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Cited by 9Aortic Disease and Treatment ApproachesAortic aneurysm repair treatmentsConnective tissue disorders research

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Postoperative glucocorticoid enhances recovery after endovascular aortic repair for chronic type B aortic dissection: a single-center experience

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Wu, Mengtao, Zhang, Lei, Bao, Junmin, Zhao, Zhiqing, Lu, Qingsheng, Feng, Rui, Song, Chao, Zhou, Jian, Jing, Zaiping·2016·BMC Cardiovascular Disorders
DOI 10.1186/s12872-016-0234-2PMC PMC4807598
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Abstract

BACKGROUND: Thoracic endovascular aortic repair (TEVAR) has been chosen as a less invasive alternative for type B aortic dissections (TBADs). However, the therapeutic effect of TEVAR has been challenged by postoperative adverse events, which were induced by inflammatory response. Glucocorticoids have been widely used because of the powerful and effective anti-inflammatory properties. Nevertheless, the prognostic effect of glucocorticoids after TBAD patients underwent TEVAR remains unclear. The objective of this study was to assess the potential effect of postoperative glucocorticoids on the prognosis of TEVAR for TBADs. METHODS: A total of 92 chronic TBADs patients underwent TEVAR with epidural anesthesia between June 2012 and June 2014 was retrospectively reviewed. The patients were stratified into dexamethasone (DXM) and non-dexamethasone group (N-DXM). The indications for TEVAR were as following: malperfusion (n = 28); contained or impending rupture (n = 17); persistent intractable chest/back pain (n = 32); refractory hypertension (n = 15). RESULTS: No 30-day mortality and incision infection occurred in each group. The postoperative pain score on the second day was significantly higher in N-DXM group (3.60 ± 0.21 versus 4.83 ± 0.32, P = 0.001). The differences of white blood cell, body temperature and heart rate were pronounced in both groups judged by the peak values (13.01 ± 0.58 × 10(9)/L versus 10.04 ± 0.61 × 10(9)/L, 37.67 ± 0.08 °C versus 37.92 ± 0.09 °C and 89.06 ± 1.21 bpm versus 95.95 ± 1.70 bpm, P = 0.002, 0.04 and 0.001, respectively). The white blood cells in DXM group significantly increased on the second and third postoperative day (P = 0.009 and 0.023), while the body temperature and heart rate showed an apparent decline on the second (P = 0.001 and 0.028), third (P = 0.007 and 0.005) and fourth postoperative days (P = 0.024 and 0.018). However, the changes of false lumen volumes and the endoleak incidence at 3-month follow-up were comparable in the two groups. No significant difference of post-implantation syndrome was observed either. CONCLUSIONS: Although postoperative prophylactic glucocorticoids administration was unable to influence mortality, incision infection or the change of false lumen volumes, it enabled to enhance the recovery of vital signs and alleviate the postoperative pain. A prospective, randomized controlled trial has been registered (NCT02523300), which will be warranted before prophylactic administration of glucocorticoids after TEVAR procedure could be recommended in the clinical work.

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Fig. 1 Flow diagram of included patients. DXM dexamethasone group, N-DXM non-dexamethasone group, TBAD stanford type B aortic dissection, TEVAR thoracic endovascular aortic repair
Fig. 1 Flow diagram of included patients. DXM dexamethasone group, N-DXM non-dexamethasone group, TBAD stanford type B aortic dissection, TEVAR thoracic endovascular aortic repairCC BY · PubMed Central
Fig. 2 Curve charts of white blood cell, body temperature and heart rate on the preoperative day and the initial five postoperative days. BPM beat per minute, DXM dexamethasone group, N-DXM non-dexamethasone group, Postop postoperative, Preop preoperative
Fig. 2 Curve charts of white blood cell, body temperature and heart rate on the preoperative day and the initial five postoperative days. BPM beat per minute, DXM dexamethasone group, N-DXM non-dexamethasone group, Postop postoperative, Preop preoperativeCC BY · PubMed Central
Fig. 3 Luminal volume calculations by the dedicated three-dimensional Aquarius Workstation CT-image processing software. a the process of three-dimensional image reconstruction; b changes in false lumen volumes in N-DXM and DXM groups; c and d, preoperative aortic morphology in DXM and N-DXM groups, respectively; e and f postoperative aortic morphology in DXM and N-DXM groups, respectively. DXM dexamethasone group, N-DXM non-dexamethasone group
Fig. 3 Luminal volume calculations by the dedicated three-dimensional Aquarius Workstation CT-image processing software. a the process of three-dimensional image reconstruction; b changes in false lumen volumes in N-DXM and DXM groups; c and d, preoperative aortic morphology in DXM and N-DXM groups, respectively; e and f postoperative aortic morphology in DXM and N-DXM groups, respectively. DXM dexamethasone group, N-DXM non-dexamethasone groupCC BY · PubMed Central

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Research works printed but not linked: 38

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Metadata

Authors
Wu, M., Zhang, L., Bao, J., Zhao, Z., Lu, Q., Feng, R., Song, C., Zhou, J., & Jing, Z.
Affiliations
Second Military Medical University (CN)
Corresponding author
  • Zhou, Jian
  • Jing, Zaiping
ORCID
Venue
BMC Cardiovascular Disorders
Publisher
Springer Science and Business Media LLC
Published
2016-03-25
Volume
16
Issue
1
Pages
59-59
ISSN
1471-2261 (ISSN-L)
DOI
10.1186/s12872-016-0234-2
PMC
PMC4807598
OpenAlex
W2306408545
Cited by
9
References
38
Citations by year
2026: 1 · 2025: 1 · 2023: 1 · 2022: 3 · 2021: 2 · 2018: 1
FWCI
0.30
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • BMC Cardiovascular Disorders (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
Funders
  • National Natural Science Foundation of China (CN) (81330034, 81273522)
  • Key Project of Basic Research in Shanghai (12JC1410802)
  • National Natural Science Foundation of China (81173072)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Aortic Disease and Treatment Approaches
  • Health Sciences › Medicine › Surgery › Aortic aneurysm repair treatments
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Connective tissue disorders research
Keywords
type B aortic dissection, thoracic endovascular aortic repair, dexamethasone, anti-inflammatory therapy, postoperative pain, inflammation, white blood cell count, fever, heart rate, postoperative recovery, prognosis, epidural anesthesia, malperfusion, aortic rupture risk, resistant hypertension, incisional infection, 30-day mortality
MeSH terms
Computed Tomography Angiography, Aortic Dissection, Aortography, China, Chronic Disease, Dexamethasone, Drug Administration Schedule, Female, Glucocorticoids, Humans, Male, Middle Aged, Pain, Postoperative, Postoperative Pain, Postoperative Care, Retrospective Studies, Time Factors, Treatment Outcome, Aortic Aneurysm, Thoracic, Blood Vessel Prosthesis Implantation, Recovery of Function, Endovascular Procedures, Multidetector Computed Tomography

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CoChat. (2026). Citation check: Postoperative glucocorticoid enhances recovery after endovascular aortic repair for chronic type B aortic dissection: a single-center experience. https://app.cochat.ai/papers/10.1186/s12872-016-0234-2
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Wu, M., Zhang, L., Bao, J., Zhao, Z., Lu, Q., Feng, R., Song, C., Zhou, J., & Jing, Z. (2016). Postoperative glucocorticoid enhances recovery after endovascular aortic repair for chronic type B aortic dissection: a single-center experience. BMC Cardiovascular Disorders. https://doi.org/10.1186/s12872-016-0234-2