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International Journal of Vascular Medicine
Volume 2011 (2011), Article ID 364046, 7 pages
http://dx.doi.org/10.1155/2011/364046
Research Article

Propensity Score-Matched Analysis of Open Surgical and Endovascular Repair for Type B Aortic Dissection

Department of Health Evidence and Policy, Mount Sinai School of Medicine, One Gustave L. Levy Place, P.O. Box 1077, New York, NY 10029, USA

Received 31 December 2010; Accepted 10 July 2011

Academic Editor: John A. Kern

Copyright © 2011 Michael E. Brunt et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective. To identify national outcomes of thoracic endovascular aortic repair (TEVAR) for type B aortic dissections (TBADs). Methods. The Nationwide Inpatient Sample database was examined from 2005 to 2008 using ICD-9 codes to identify patients with TBAD who underwent TEVAR or open surgical repair. We constructed separate propensity models for emergently and electively admitted patients and calculated mortality and complication rates for propensity score-matched cohorts of TEVAR and open repair patients. Results. In-hospital mortality was significantly higher following open repair than TEVAR (17.5% versus 10.8%, P = .045) in emergently admitted TBAD. There was no in-hospital mortality difference between open repair and TEVAR (5.6% versus 3.3%, P = .464) for elective admissions. Hospitals performing thirty or more TEVAR procedures annually had lower mortality for emergent TBAD than hospitals with fewer than thirty procedures. Conclusions. TEVAR produces better in-hospital outcomes in emergent TBAD than open repair, but further longitudinal analysis is required.