Contemporary endovascular treatment of type B aortic dissection in China.

Abstract

Endovascular stent-grafts have been used in China to treat type B aortic dissection since 1999, and there is a plethora of cohort studies in the contemporary literature. The aim of this review was to analyse the published results of endovascular treatment for type B aortic dissection in China. A systematic literature review of all published literature from January 1999 to October 2014 on endovascular treatment of type B aortic dissection in China was undertaken using PubMed, Medline, and the Chinese National Knowledge Infrastructure databases. Seventy papers were retrieved (4 English, 66 Chinese) with a total of 4208 patients; 3396 (80.7%) were male, and the mean age ranged from 43 to 65 years. Procedural success was reported in 99.4% ± 1.7%. Complications were reported in 14.6% ± 11.1%, with major complications in 1.7% ± 2.9%, and the most devastating neurologic complications in 1.1% ± 2.2% (stroke 0.9% ± 2.4%, paraplegia 1.5% ± 0.7%). Postoperative endoleak occurred in 8.1% ± 7.6%. The 30-day postoperative mortality was 2.4% ± 3.3%. During follow-up, false-lumen thrombosis occurred in 92.1% ± 11.7%. Reintervention was performed in 1.3% ± 3.3%. The incidence of proximal and distal stent-graft-induced new entry was 0.5% ± 1.3% and 0.9% ± 2.7%, respectively, with endoleak in 2.7% ± 4.4% and mortality of 2.2% ± 3.2%. Current evidence suggests that use of endovascular stent-grafts for type B aortic dissection in China is feasible and safe with low rates of perioperative complications and short-term mortality. However, a standardised reporting system and long-term follow-up data are lacking.