To investigate the influencing factors of poor remodeling of distal aorta after thoracic endovascular repair (TEVAR) in patients with acute Stanford B aortic dissection.

The clinical data of patients with acute Stanford B aortic dissection who received TEVAR treatment in our department from January 2015 to December 2020 were retrospectively collected, the changes of multiplanar true and false lumens at the distal end of the stent-graft were observed, and the influencing factors of poor aortic remodeling at the distal end of the stent-graft were analyzed.

A total of 82 patients were included, 58 (70.7%) of them had hypertension, 57 (69.5%) of them had dissection extending to the iliac artery. During the follow-up period, 15 (18.3%) patients had false lumen expansion at the distal end of the stent-graft. The angle between the distal end of the stent-graft and the aorta, the number of tears above the celiac trunk, the number of remaining tears after procedure and the number of type I endoleaks at the last follow-up in the false lumen expansion group were greater than those in the non-expansion group. The length of thrombus in the false lumen expansion group was smaller than that in the non-expansion group. The above differences were statistically significant (all P < 0.05). Multivariate analysis showed that an excessive angle between the distal end of the stent-graft and the aorta (OR = 1.282, 95%CI: 1.104~1.486, P = 0.001), and a large number of remaining tears (OR = 3.282, 95%CI: 1.035~10.401, P < 0.043) were risk factors for poor aortic remodeling after TEVAR.

The large angle between the distal end of the stent-graft and the aorta, and the large number of residual tears are risk factors for poor remodeling of the distal aorta after TEVAR.