Propensity Score-Matched Analysis of Open Surgical and Endovascular Repair for Type B Aortic Dissection
2011

Comparing TEVAR and Open Surgery for Type B Aortic Dissection

Sample size: 4752 publication Evidence: moderate

Author Information

Author(s): Michael E. Brunt, Natalia N. Egorova, Alan J. Moskowitz

Primary Institution: Mount Sinai School of Medicine

Hypothesis

Does thoracic endovascular aortic repair (TEVAR) provide better outcomes than open surgical repair for type B aortic dissections?

Conclusion

TEVAR results in better in-hospital outcomes for emergently admitted patients with type B aortic dissection compared to open repair.

Supporting Evidence

  • In-hospital mortality was significantly higher following open repair than TEVAR in emergently admitted TBAD patients (17.5% vs 10.8%).
  • There was no significant difference in in-hospital mortality between open repair and TEVAR for elective admissions (5.6% vs 3.3%).
  • Hospitals performing thirty or more TEVAR procedures annually had lower mortality for emergent TBAD than hospitals with fewer than thirty procedures.

Takeaway

Doctors found that a less invasive surgery called TEVAR is safer than traditional surgery for patients with a serious type of aortic problem when they come to the hospital in an emergency.

Methodology

The study analyzed data from the Nationwide Inpatient Sample database from 2005 to 2008, comparing outcomes of TEVAR and open surgical repair using propensity score matching.

Potential Biases

Potential selection bias due to differences in patient demographics and comorbidities between treatment groups.

Limitations

The study is observational and may have biases due to differences in patient characteristics and coding errors in comorbidity data.

Participant Demographics

Patients included both emergently and electively admitted individuals with type B aortic dissections, with varying comorbidities.

Statistical Information

P-Value

0.045

Statistical Significance

p=0.045

Digital Object Identifier (DOI)

10.1155/2011/364046

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