title: Prognostic factors in patients with uncomplicated acute type B aortic dissection.
abstract: BACKGROUND
  The benefit of thoracic endovascular aortic repair (TEVAR) for uncomplicated acute type B aortic dissection is unclear. Reliable prognostic factors are needed to identify candidates for prophylactic TEVAR. The aim of this study was to detect prognostic factors in patients with uncomplicated acute type B aortic dissection.
  
  
  METHODS
  From January 2003 to April 2012, a total of 228 patients with uncomplicated acute type B aortic dissection were admitted to our institute. Cox proportional hazards analysis was performed to identify risk factors for death, dissection-related death, and aortic events.
  
  
  RESULTS
  Independent predictors of mortality were age (hazard ratio [HR], 1.08; p < 0.001) and false lumen thickness (mm) (HR, 1.10; p = 0.013), and the risk factor for dissection-related death was false lumen thickness (mm) (HR, 1.14; p < 0.001). Independent risk factors for aortic events were diameter of the descending aorta (mm) (HR, 1.14; p < 0.001) and entry in a proximal site (HR, 2.90; p = 0.02). The actuarial freedom from aortic events in patients with a descending aortic diameter of less than 40 mm and no entry in a proximal site at 1, 3, and 5 years was 96.6%, 90.8%, and 82.5%, respectively, whereas in patients with 1 of these 2 factors, it was 80.1%, 66.8%, and 53.5%, respectively.
  
  
  CONCLUSIONS
  In uncomplicated acute type B aortic dissection, the diameter of the descending aorta and entry in a proximal site were independent prognostic factors for aortic events. Prophylactic TEVAR should be considered for patients with these risk factors.
authors.affiliation: Department of Cardiovascular Surgery, Kurashiki Central Hospital, Kurashiki, Japan. Electronic address: u.chikara.0404@gmail.com.
authors.forename: Chikara
authors.initials: C
authors.lastname: Ueki
authors.affiliation: Department of Cardiovascular Surgery, Kurashiki Central Hospital, Kurashiki, Japan.
authors.forename: Genichi
authors.initials: G
authors.lastname: Sakaguchi
authors.affiliation: Department of Cardiovascular Surgery, Kurashiki Central Hospital, Kurashiki, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Shimamoto
authors.affiliation: Department of Cardiovascular Surgery, Kurashiki Central Hospital, Kurashiki, Japan.
authors.forename: Tatsuhiko
authors.initials: T
authors.lastname: Komiya
mesh_terms: D000208:Acute Disease; D000368:Aged; D001018:Aortic Diseases / Q000145:classification / Q000401:mortality* / Q000601:surgery*; D057510:Endovascular Procedures; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D013906:Thoracoscopy