Role of CTA Surveillance for Management of Endovascular Repair of Aortic Dissection

Objectives: The aim of this study was to evaluate the effect of timing for post-interventional CT imaging on the rate of re-intervention and all-cause mortality in patients with endovascular treatment of type B aortic dissections (TBAD). Material and methods: Data on 70 patients with endo-vascular repair of aortic dissection during a three-year period from a single institution retrospectively were collected. Study participants were stratified based on those who had a post-operative CTA in the first 30 days after index intervention (early) vs. those who did not (late). The re-intervention and all-cause mortality rates between the two groups were investi-gated using Kaplan-Meier and Cox regression analysis. Results: During a median follow-up time of 230 days, the primary endpoint (additional operation) was reached in 24/70 patients (34.3%) with no statistically significant differ-ence between the early and late CTA group (log-rank-test: P = 0.886). All-cause mortality was present in 14/70 (20%) patients, with no statistically significant difference between both groups (log-rank-test: P = 0.440). Additionally, both groups had no significant differences in time to additional operation and death. Cox regression analysis revealed the presence of a chronic TBAD and underlying connective tissue disease as relevant risk factors for the need for an addi-tional operation and obesity as a protective and renal failure as a negative factor for all-cause mortality. Conclusion: CTA surveillance within 30 days of the index operation did not significantly modify mortality or rate of re-intervention after endovascular treatment for TBAD. Sur-veillance recommendations should be tailored to individual-ized factors.