Analysis of risk factors for postoperative acute cerebral infarction in patients with type B aortic dissection.

OBJECTIVE

To study risk factors of postoperative acute cerebral infarction (PACI) in patients with type B aortic dissection (TB-AD).

METHODS

The data of 36 patients with TB-AD and PACI undergoing endovascular aortic repair (EVAR) from Mar 2018 and Mar 2021 were collected as the PACI group retrospectively. The data of 114 TB-AD patients without PACI were collected as the control group retrospectively. The medical history, surgery-related indicators, general data, imaging data and laboratory test results (D-dimer (D-D), preoperative serum creatinine and preoperative white blood cell count) were compared. Then, logistic regression was applied to analyze risk factors for PACI in TB-AD patients.

RESULTS

The surgery time, blood loss and hospital stay of patients in the PACI group were determined to be obviously higher/longer when comparing to those in the control group. Aortic arch radius of curvature and length of proximal anchoring zone showed no significant difference between the two groups. Pearson correlation analysis indicated that D-D level after surgery was positively related to white blood cell count and serum creatinine level in TB-AD patients. Binary logistic regression analysis showed that operation time, emergency surgery, preoperative D-D and preoperative serum creatinine level were independent risk factors for PACI after EVAR in the patients with TB-AD (P < 0.05).

CONCLUSION

There are many independent risk factors for PACI after EVAR in patients with TB-AD, and preoperative D-D level and serum creatinine level should be given attention.