Risk Factors for Adverse Events in Stanford Type B Aortic Dissection After TEVAR Surgery
LIU Lei
FA Xianen
ZHU Rui
ZHANG Ning
Abstract：Objective To analyze the risk factors for adverse events in patients with Stanford type B aortic dissection undergoing thoracic edovascular aortic repair(TEVAR),and develop a predictive model to guide clinical doctors in preventing adverse events after TEVAR surgery.Methods A retrospective analysis was conducted on 182 patients with Stanford type B aortic dissection who received TEVAR treatment at the Second Affiliated Hospital of Zhengzhou University from January 2018 to July 2023.Based on whether adverse events such as acute cerebral infarction and severe infection occurred after TEVAR surgery,the 182 patients were divided into adverse event group(38 cases)and complete rehabilitation group(144 cases).The general information between the two groups was compared,and data with P＜0.10 were included in a multivariate logistic analysis to screen for independent risk factors for adverse events after TEVAR surgery.R 4.3.1 software was used to plot the risk factors into a column chart prediction model,and receiver operating characteristic(ROC)curve,calibration curve,DCA decision curve,and other tests were used to evaluate the predictive performance of the prediction model.Results In the multivariate logistic regression analysis,it was found that white blood cell count,primary rupture width,and time from symptom onset to TEVAR treatment were independent risk factors for adverse events after TEVAR treatment for patients.The R 4.3.1 software was used to create a column chart prediction model for adverse events after surgery.The area under the ROC curve value was 0.894(95％CI:0.845-0.943),and the prediction model had good discrimination and was superior to predicting adverse events after TEVAR treatment with different independent risk factors alone.The model development set in the calibration curve was close to the ideal model,indicating good performance of the predictive model.The DCA decision curve suggested that the net return of the prediction model was good when the risk threshold was between 0.03 and 1.0,indicating better clinical practical value in this range.Conclusion Increased white blood cell count,increased primary wound width,involvement of proximal dissection in zone 2 or above,time from symptom onset to TEVAR,and complex Stanford type B aortic dissection are independent risk factors for adverse events after TEVAR for Stanford type B aortic dissection.The clinical model constructed based on the above independent risk factors has good predictive performance and has certain clinical practical value.
Keywords：Stanford type B aortic dissectionthoracic endovascular aortic repairrisk factorprediction model
Publication Date：2025-04-28
Online Publishing Date：2026-09-12(First online date of this platform, not the publication date of the document)
Pages：6( 1351-1356 )