This study aimed to evaluate the long-term survival and risk factors of traditional
open surgical repair (OSR) vs thoracic endovascular aneurysm repair
(TEVAR) for complicated type-B aortic dissection (TBAD). A total of 118 inpatients
(45 OSR vs 73 TEVAR) with TBAD were enrolled from January 2004 to
January 2015. Kaplan-Meier curves and Cox proportional hazards analysis were
performed to identify the long-term survival rate and independent predictors of
survival, respectively. Meta-analysis was used to further explore the long-term
efficacy of OSR and TEVAR in the eight included studies using Review Manager 5.2
software. An overall 10-year survival rate of 41.9% was found, and it was similar in
the two groups (56.7% OSR vs 26.1% TEVAR; log-rank P=0.953). The
risk factors of long-term survival were refractory hypertension (OR=11.1;
95%CI=1.428-86.372; P=0.021] and preoperative aortic diameter >55
mm (OR=4.5; 95%CI=1.842-11.346; P=0.001). Long-term survival rate
did not differ significantly between OSR and TEVAR (hazard ratio=0.87;
95%CI=0.52-1.47; P=0.61). Compared with OSR, TEVAR did not show
long-term advantages for patients with TBAD. Refractory hypertension and total aortic
diameter >55 mm can be used to predict the long-term survival of TBAD in the
Chinese Han population.
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