# Long-Term Outcomes of Endovascular Treatment for Type B Aortic Dissection with Simple Renal Cysts: A Multicenter Retrospective Study

## TL;DR

This study finds that type B aortic dissection patients with simple renal cysts face higher long-term risks after aortic repair surgery.

## Contribution

The study identifies simple renal cysts as an independent predictor of adverse aortic events after TEVAR in type B aortic dissection patients.

## Key findings

- BAD patients with SRC had higher long-term aortic-related adverse events after TEVAR.
- SRC was an independent predictor of adverse events (hazard ratio: 1.84).
- SRC combined with hypertension significantly increased rupture risk after TEVAR.

## Abstract

Few studies have investigated the characteristics and
long-term outcomes of type B aortic dissection (BAD) patients with simple renal
cysts (SRC) after thoracic endovascular aortic repair (TEVAR).

A multi-center retrospective cohort study was performed, including 718 BAD
patients undergoing TEVAR from 2003 to 2016. The prevalence of SRC was 34.5% (n
= 248). After propensity score matching, 214 matched pairs were selected for
further analysis. Primary outcomes were long-term aortic-related adverse events
(ARAEs). The effects of SRC in each subgroup of interest and their interactions
were analyzed.

BAD patients with SRC were older and had a
greater prevalence of comorbidities, including hypertension, coronary artery
disease and chronic occlusive pulmonary disease. In addition, the SRC group
presented a greater proportion of pleural effusion and aortic calcification.
Compared with the non-SRC group, a significantly higher maximal diameter of
ascending aorta was observed in the SRC group. Apart from the timing of the
operation, no differences were found in the medication regime or intra-operative
parameters. In the matched population, patients with SRC were at a higher risk of
ARAEs in the long term. The multivariable Cox model indicated that SRC was an
independent predictor of long-term ARAEs (hazard ratio: 1.84, 95% confidence
interval: 1.13–3.00). The interaction between SRC and hypertension on rupture
after TEVAR was statistically significant (p = 0.023).

Compared with the non-SRC group, BAD patients with SRC
experienced a higher risk of long-term ARAEs after TEVAR. Among the SRC subgroup,
hypertensive patients had the highest risk of rupture after TEVAR.