Unique Characteristics of the Type B Aortic Dissection Patients With Malperfusion in the Vascular Quality Initiative

Abstract Objective Type B Aortic Dissection (TBAD) complicated by malperfusion carries a high morbidity and mortality rate. This study was undertaken to compare the characteristics of the malperfusion and uncomplicated cohorts, as well as evaluate long-term differences in survival, utilizing a granular, national registry. Methods Patients with TBAD entered into the TEVAR/Complex EVAR module of the VQI from 2010-2019 were included. Demographic, radiographic, operative, postoperative, in-hospital and long-term reinterventions were compared between the malperfusion and uncomplicated patients using t-tests and chi-square analysis where appropriate. Overall survival was compared using Cox regression to generate survival curves. Results There were 2,267 uncomplicated and 553 malperfusion patients included. Notably, malperfusion patients were younger (55.8 vs 61.2 years, p Conclusions Patients presenting with TBAD and malperfusion represent a unique cohort of patients. Despite the greater need for branch vessel stenting as well as in-hospital reintervention, they have a similar long-term reintervention rate and survival compared to uncomplicated TBAD patients. These data lend insight with regard to observed differences between uncomplicated and malperfusion TBAD.