胸主动脉腔内修复术(thoracic endovascular aortic repair，TEVAR)作为目前有效治疗Stanford B型主动脉夹层(type B aortic dissection，TBAD)的主要方法，其术后存在的死亡风险对于TBAD患者的生存质量仍然是巨大的挑战，且该风险问题造成的社会经济负担也显著增加，需重点关注。研究证实，TBAD患者TEVAR术后不良事件问题普遍存在，尤其是TEVAR术后死亡风险较高，是影响患者生存结局的关键因素。而TBAD患者TEVAR术后死亡问题主要受到基线资料(年龄、心率、血压、既往病史)、检验指标(炎症指标、肾功能、凝血-纤溶指标)、手术指标(干预时机、手术时长、支架数量、支架材料、支架置入位置)、术后不良事件(内漏、心脏压塞、假腔破裂、心肌梗死、支架源性新发破口、术后支架感染、脏器灌注不良)、遗传基因等因素的综合影响。未来研究可根据TBAD患者TEVAR术后死亡问题的特定影响因素进行风险分层和早期预警，对实现精准治疗和改善预后具有重要意义。
Current status and risk factors of postoperative mortality in patients with Stanford type B aortic dissection undergoing TEVAR surgery
Thoracic endovascular aortic repair(TEVAR)is currently the main effective method and means for treating stanford type B aortic dissection(TBAD).However,the risk of postoperative mortality remains a huge challenge for the quality of life of TBAD patients,and the social and economic burden caused by this risk issue has significantly increased,requiring special attention.Research has confirmed that adverse events after TEVAR surgery are common in TBAD patients,especially with a higher risk of mortality after TEVAR surgery,which is a key factor affecting patient survival outcomes.The mortality issues of TBAD patients after TEVAR surgery are mainly affected by baseline data(age,heart rate,blood pressure,past medical histo-ry),test indicators(inflammation indicators,renal function,coagulation fibrinolysis indicators),surgical indicators(interven-tion timing,surgical duration,number of stents,stent material,stent placement location),postoperative adverse events(in-ternal leakage,cardiac tamponade,false lumen rupture,myocardial infarction,stent derived new rupture,postoperative stent infection and organ malperfusion).The comprehensive influence of genetic and other factors.Future research can stratify risks and provide early warning based on specific influencing factors of TEVAR postoperative mortality in TBAD patients,which is of great significance for achieving precise treatment and improving prognosis.
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