ORIGINAL RESEARCH article
Front. Cardiovasc. Med.
Sec. Intensive Care Cardiovascular Medicine
Volume 12 - 2025 | doi: 10.3389/fcvm.2025.1633817
This article is part of the Research TopicInnovative Monitoring and Management of Perioperative Complications in Cardiac SurgeryView all 6 articles
Evaluation of Perivascular Fat Density and Residual False Lumen Formation Following TEVAR in Stanford Type B Aortic Dissection
Provisionally accepted
- Shengli Clinical Medical College, Fujian Medical University, Fuzhou, China
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Objective:This study aims to investigate the role of perivascular adipose tissue (PVAT) attenuation in predicting residual false lumen formation following thoracic endovascular aortic repair (TEVAR) in patients with Stanford Type B aortic dissection (TBAD). The focus is on the association between PVAT attenuation (HU Δ and HUratio) and postoperative outcomes, particularly the development of residual false lumen. Methods:A retrospective analysis was conducted on 132 patients who underwent TEVAR for TBAD at Fujian Provincial Hospital between 2016 and 2024. Patients were classified into two groups based on postoperative imaging findings: those with residual false lumen and those with completely closed false lumen. Data collected included demographic, biochemical, and imaging parameters. PVAT was assessed using computed tomography angiography (CTA), with the TotalSegmenter deep learning model used for automatic segmentation. Two indicators-Hounsfield unit difference (HU Δ ) and Hounsfield unit ratio (HUratio)-were calculated. Results:Patients with residual false lumen showed significantly higher HU Δ (8.75±3.29 vs. 5.16 ±2.84, P < 0.001) and lower HUratio (0.73±0.13 vs. 0.85±0.11, P < 0.001) compared to those with closed false lumen. Multivariate logistic regression identified HU Δ and HUratio as independent predictors of residual false lumen formation after TEVAR. ROC curve analysis revealed optimal cut-off values for predicting residual false lumen: HU Δ >7.170 (sensitivity 0.895, specificity 0.762) and HUratio≤0.790 (sensitivity 0.947, specificity 0.667). Conclusions:PVAT attenuation, reflected by HU Δ and HUratio, serves as a significant, non-invasive imaging biomarker for predicting residual false lumen formation after TEVAR in TBAD patients. These findings suggest that preoperative evaluation of PVAT characteristics can help identify high-risk patients and guide postoperative management strategies. Further prospective studies are needed to validate these findings and explore the potential of PVAT modulation in improving long-term outcomes following TEVAR.
Keywords: perivascular adipose tissue, Thoracic endovascular aortic repair, Stanford type B aortic dissection, Residual False Lumen, Hounsfield unit, Biomarker prediction
Received: 23 May 2025; Accepted: 29 May 2025.
Copyright: © 2025 He, Zhong, Cao and Cheng. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Hua Cao, Shengli Clinical Medical College, Fujian Medical University, Fuzhou, China
Zhangbo Cheng, Shengli Clinical Medical College, Fujian Medical University, Fuzhou, China
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