Analysis of the factors related to the early outcomes of Type B Acute Aortic Syndromes

Abstract

Objective: To determine the outcomes of endovascular treatment (ET) of Type B Acute Aortic Syndrome (AAS) and factors related to mortality and Spinal Cord ischemia. Methods: This was a retrospective cohort of complicated AAS patients who underwent endovascular treatment. The primary outcome variable was mortality rate and clinical outcomes. The secondary outcome variable was SCI. Results: Overall, 32 patients were evaluated, 10 patients submitted to CM and 22 patients ET. 100% of the patients had arterial hypertension, with a higher prevalence of male gender (53.1%). There was a higher prevalence of acute aortic dissection Stanford B with 19 cases (59.4%). Among the 22 patients submitted to interventional therapy, most of them thoracic endoprosthesis (TEVAR), with 16 patients (72.7%). A logistic regression showed that refractory chest pain (HR = 9,57; p = 0.005), aortic diameter higher than 40mm (HR = 16.65; p < 0.001), chronic renal failure (CRF) (HR = 5.2; p = 0.009) and SCI (HR = 1.89; p = 0.029) were related to increased mortality rate. Otherwise, male gender (MG) (HR = 17.20; p < 0.001), concomitant TEVAR + EVAR (HR = 3.88; p = 0.048), malperfusion (HR = 3.88; p = 0.038) and number of internal iliac patency (IIP) (HR = 6.52; p = 0.016) were associated to SCI. Conclusion: This study concluded that refractory chest pain, aortic diameter higher than 40mm, CRF and SCI were related to increased mortality rate. MG, concomitant TEVAR + EVAR, malperfusion and number of IIP were associated to SCI.