A systematic review on contemporary endovascular treatment of type B aortic dissection in China

Abstract

OBJECTIVE: Endovascular stent-grafts had been used since 1999 in China for the treatment of type B aortic dissection, and there is a plethora of cohort studies in the contemporary literature. The aim of this paper is to analyze the published results of endovascular treatment for type B aortic dissection in China. METHOD: A systematic literature review was undertaken of all published literature from January 1999 to December 2014 on endovascular treatment of type B aortic dissection in China using PubMed, MEDLINE and Chinese National Knowledge Infrastructure (CNKI) databases. RESULTS: There were 70 papers retrieved (4 English, 66 Chinese) with a total of 4208 patients. 3396 patients (80.7%) were males, mean age ranged from 43 to 65 years. Procedural success was reported in 99.4 ± 1.7% of patients, 5 patients required emergency conversion to open operation. Overall complications were reported in 14.6 ± 11.1% of the patients. Major complications were reported in 1.7 ± 2.9% with the most devastating neurologic complications in 1.1 ± 2.2%. The incidence of stroke and paraplegia was 0.9 ± 2.4% and 1.5 ± 0.7%, respectively. Postoperative endoleak was observed in 8.1 ± 7.6%. The 30-day post-operative mortality was 2.4 ± 3.3%. During the follow-up, false lumen thrombosis were observed in 92.1 ± 11.7%. Re-intervention was performed in 1.3 ± 3.3% of the patients. Endoleak was observed in 2.7 ± 4.4%, mortality was 2.2 ± 3.2%. CONCLUSIONS: Current evidence seems to suggest that endovascular stent-graft for type B aortic dissection in China is feasible and safe with low perioperative complication and short-term mortality. However, standardised reporting system and long-term follow data is lacking.