Abstract

Objective: To determine the effect of renal artery stenosis (RAS) resulting from acute type B aortic dissection (ATBAD) with thoracic endovascular aortic repair (TEVAR) on early prognosis in patients with ATBAD.Methods: A total of 129 ATBAD patients in the National Acute Aortic Syndrome Database (AASCN) who underwent TEVAR between 2019 and 2020 were enrolled in our study. Patients were divided into two groups: the RAS group and the non-RAS group.Results: There were 21 RAS patients (16.3%) and 108 non-RAS patients (83.7%) in our cohort. No patient in our cohort died during the 1-month follow-up. There was no significant difference in preoperative creatinine clearance rate (CCr) between the two groups (90.6 ± 46.1 μmol/L in the RAS group vs. 78.7 ± 39.2 μmol/L in the non-RAS group, P = 0.303) but the RAS group had a significantly lower estimated glomerular filtration rate (eGFR) than the non-RAS group (83.3 ± 25.0 vs. 101.9 ± 26.9 ml/min, respectively; P = 0.028).One month after TEVAR, CCr was significantly higher (99.0 ± 68.1 vs. 78.5 ± 25.8 ml/min, P = 0.043) and eGFR (81.7 ± 23.8 vs. 96.0 ± 20.0 ml/min, P = 0.017) was significantly lower in the RAS group than in the non-RAS group.Conclusions: In ATBAD, RAS could result in acute kidney injury (AKI) in the early stage after TEVAR. The RAS group had a high incidence of hypertension. These results suggest that patients with RAS may need further treatment.

Highlights

  • Acute type B aortic dissection (ATBAD) refers to dissection involving the distal left subclavian artery [1, 2]

  • This study aims to focus on the effects of ATBAD-induced Renal artery stenosis (RAS) on early renal function and hypertension after TEVAR

  • There was no significant difference in baseline data between the RAS population and the non-RAS population

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Summary

Introduction

Acute type B aortic dissection (ATBAD) refers to dissection involving the distal left subclavian artery [1, 2]. Renal artery involvement (RAI) is one of the common complications of ATBAD, with an incidence rate of 45–48% [3, 4]. Some researchers found that RAI did not affect the perioperative renal function of patients with ATBAD. Based on the results of their study, they concluded that the RAI caused by ATBAD can be treated conservatively [3, 5]. Previous studies on RAI in patients with ATBAD have demonstrated little detailed classification of renal artery injury.

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