Risk Factor Analysis of Post-TEVAR Distal Aortic Expansion: A Systematic Review and Meta-Analysis

DAE after TEVAR is determined by a combination of patient comorbidities and aortic remodeling features. Identifying high-risk profiles-such as male sex, cardiovascular comorbidities, and persistent false lumen-may help optimize surveillance and reduce late aortic complications.Clinical ImpactDistal aortic expansion (DAE) remains a major determinant of late failure after TEVAR for type B aortic dissection. This study provides a comprehensive quantitative synthesis of clinical and remodeling-related predictors of DAE, highlighting high-risk profiles such as male sex, hypertension, prior myocardial infarction, peripheral vascular disease, and persistent false lumen patency. By integrating demographic, comorbidity, and morphological factors, the findings support a risk-adapted surveillance strategy rather than uniform follow-up protocols. Importantly, the study underscores the prognostic significance of false lumen dynamics, reinforcing the role of adjunctive techniques aimed at promoting distal thrombosis. These insights may facilitate individualized monitoring, earlier intervention, and improved long-term durability after TEVAR.