Long-Term Outcomes of Antegrade Thoracic Stent Grafting During Repair of Acute DeBakey I Dissection.

Background We aim to evaluate the impact of antegrade stenting of the distal arch and proximal descending aorta combined with non-total arch procedures in acute type A aortic dissection.Methods From 2005 to 2022, 733 non-syndromic patients presented with acute DeBakey type I aortic dissection and underwent non total arch procedure. Ninety-five patients underwent antegrade stenting and 638 did not. Propensity-score analysis was performed, and 95 optimal pairs were created. Survival was estimated using the Kaplan-Meier method and cumulative incidence of reintervention with death as a competing event was calculated and compared using Gray's method.Results Survival estimates at 10 years after propensity score matching were similar between both group 58.9% (95%CI: 46.5-74.5) versus 58.4% (95%CI: 48.3-70.6) (p=0.6) in the non-stented versus stented group respectively. Cumulative incidence of reintervention with competing risk of death at 10 years after propensity matching was 27% (95%CI: 17-37) versus 22% (95%CI: 14-32) (p=0.44).Conclusions Antegrade TEVAR may be beneficial for remodeling and facilitating future endovascular reinterventions and reduces the occurence of reintervention for malperfusion.