Hongqiao Zhu1, Lei Zhang1, Taiping Liang1, Yiming Li1, Jian Zhou2, Zaiping Jing3. 1. Department of Vascular Surgery, Changhai Hospital, Navy Medical University, Shanghai, 200433, China. 2. Department of Vascular Surgery, Changhai Hospital, Navy Medical University, Shanghai, 200433, China. zhoujian1-2@163.com. 3. Department of Vascular Surgery, Changhai Hospital, Navy Medical University, Shanghai, 200433, China. jingzaiping_vasc@163.com.
Abstract
BACKGROUND: Thoracic aortic endovascular repair (TEVAR) of uncomplicated type B aortic dissection (uTBAD) has favorable long-term outcomes but higher early adverse events compared with the optimal medical treatment. Recently, clinical evidence concerning vascular surgery indicates that elevated preoperative systemic inflammatory response predicts adverse clinical events. The aim of our study was to evaluate the relationship between preoperative neutrophil-to-lymphocyte ratio (NLR) and early outcomes of uTBAD patients undergoing TEVAR. RESULTS: 216 patients diagnosed with uTBAD were included in this retrospective study between January 2015 and December 2018. The median (IQR) follow-up period was 21 (15-33) months. An early adverse event was defined as occurring within 2 years after the procedure. Median patient age was 60 (IQR, 48-68) years and 78.7 % were male. Early adverse events occurred in 24 patients (11.1 %). In the multivariable analysis, preoperative NLR (HR per SD, 1.98; 95 % CI, 1.14-3.44; P = 0.015) was associated with 2-year adverse events. CONCLUSIONS: NLR is an independent predictive factor of early adverse events in uTBAD patients undergoing TEVAR.
BACKGROUND: Thoracic aortic endovascular repair (TEVAR) of uncomplicated type B aortic dissection (uTBAD) has favorable long-term outcomes but higher early adverse events compared with the optimal medical treatment. Recently, clinical evidence concerning vascular surgery indicates that elevated preoperative systemic inflammatory response predicts adverse clinical events. The aim of our study was to evaluate the relationship between preoperative neutrophil-to-lymphocyte ratio (NLR) and early outcomes of uTBAD patients undergoing TEVAR. RESULTS: 216 patients diagnosed with uTBAD were included in this retrospective study between January 2015 and December 2018. The median (IQR) follow-up period was 21 (15-33) months. An early adverse event was defined as occurring within 2 years after the procedure. Median patient age was 60 (IQR, 48-68) years and 78.7 % were male. Early adverse events occurred in 24 patients (11.1 %). In the multivariable analysis, preoperative NLR (HR per SD, 1.98; 95 % CI, 1.14-3.44; P = 0.015) was associated with 2-year adverse events. CONCLUSIONS: NLR is an independent predictive factor of early adverse events in uTBAD patients undergoing TEVAR.
Entities:
Keywords:
Inflammatory markers; Neutrophil‐to‐lymphocyte ratio; Systemic inflammatory response; Thoracic endovascular aortic repair; Uncomplicated type B aortic dissection