{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,23]],"date-time":"2026-05-23T06:04:37Z","timestamp":1779516277085,"version":"3.53.1"},"reference-count":41,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2025,9,17]],"date-time":"2025-09-17T00:00:00Z","timestamp":1758067200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Vascular"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>There is a lack of consensus on the benefit of early thoracic endovascular aortic repair (TEVAR) over medical management for uncomplicated acute type B aortic dissection (aTBAD). The aim of this study is to compare readmissions of TEVAR versus medical management as the initial treatment strategy for uncomplicated aTBAD using the Nationwide Readmissions Database (NRD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The NRD was created under the Healthcare Cost and Utilization Project, comprising over half of the U.S. inpatient population. Patients admitted for uncomplicated aTBAD were queried from the NRD from 2016 to 2018. Risk of index admission mortality, spinal cord ischemia, stroke, and overall major complication; 90-day readmission and 90-day treatment failure, between TEVAR and medical management alone.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 12,645 patients with an uncomplicated aTBAD were identified (TEVAR 12% and medical management 88%). Overall major complications during index admission were higher in the medical management group (27% vs 40%,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; .0001). On multivariate analysis TEVAR was associated with lower mortality (OR: 0.47,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; .0001), but a significantly higher rate of spinal cord ischemia (OR: 2.49,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; .0001), with no difference in stroke (OR: 0.93,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = .73). 90-day readmission rates were high but were not significantly different between treatment types (22% vs 25%, OR: 0.88,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = .14). Similarly, TEVAR was not associated with a lower rate of 90-day treatment failure (OR: 0.61,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = .22). Four TEVAR (0.3%) and 40 medical management (0.5%) patients were readmitted for treatment failure due to retrograde type A dissection.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>TEVAR for uncomplicated aTBAD was not associated with a lower 90-day readmission rate. Similarly, TEVAR was not associated with a lower rate of 90-day treatment failure. These findings provide further evidence to the equipoise of treatment options and support the need for the randomized trials currently ongoing in the U.S. and Europe investigating outcomes of TEVAR versus medical management for the treatment of uncomplicated aTBAD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17085381251379293","type":"journal-article","created":{"date-parts":[[2025,9,17]],"date-time":"2025-09-17T07:15:11Z","timestamp":1758093311000},"page":"561-571","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Readmission following early thoracic endovascular aortic repair compared to optimal medical treatment for uncomplicated acute type B aortic dissection"],"prefix":"10.1177","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4565-3211","authenticated-orcid":false,"given":"Elliott A","family":"Orloff","sequence":"first","affiliation":[{"name":"University of Arizona College of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Ding","sequence":"additional","affiliation":[{"name":"Keck School of Medicine, University of Southern California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8398-6992","authenticated-orcid":false,"given":"Jeniann","family":"Yi","sequence":"additional","affiliation":[{"name":"University of Colorado Anschutz Medical Campus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0715-4606","authenticated-orcid":false,"given":"Sukgu M","family":"Han","sequence":"additional","affiliation":[{"name":"Keck School of Medicine of USC, University of Southern California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory A","family":"Magee","sequence":"additional","affiliation":[{"name":"Keck School of Medicine of USC, University of Southern California"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,9,17]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.283.7.897"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.106.622340"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2024.05.055"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCINTERVENTIONS.113.000463"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2013.05.003"},{"issue":"3","key":"e_1_3_4_7_2","first-page":"234","article-title":"Management of complicated and uncomplicated acute type B dissection. 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