{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T00:03:42Z","timestamp":1777421022700,"version":"3.51.4"},"reference-count":12,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2024,2,23]],"date-time":"2024-02-23T00:00:00Z","timestamp":1708646400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>The most appropriate surgical method for patients with uncomplicated type B aortic dissection (UTBAD) in the chronic phase remains controversial. This study evaluated the outcomes of patients with UTBAD who needed aortic treatment as well as the impact of the treatment method or indication criteria on their prognosis.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>This retrospective review of 106 consecutive patients with aortic events in the chronic phase who underwent initial treatment for UTBAD between 2004 and 2021 comprised three groups: 19 patients who underwent endovascular repair (TEVAR), 38 who underwent open aortic repair and the medication group that included 49 patients. Aortic events were defined as a late operation or indication for operation for dissected aorta, aortic diameter (AD) \u2265 55 mm, rapid aortic enlargement (\u22655 mm\/6 months), and saccular aneurysmal change. The endpoint was all-cause death. We assessed the association between treatment methods or surgical indication criteria and mortality using a Cox regression analysis.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>The 5-year actuarial mortality rates were 27.1% in the TEVAR group, 19.6% in the open aortic repair group, and 38.4% in the medication group (<jats:italic>p<\/jats:italic> = 0.86). Moreover, the 5-year actuarial mortality rates in patients who had AD \u2265 55 mm were significantly higher than those patients with other surgical indication criteria (41.2% vs. 18.7%, p &lt; 0.01). Multivariable analysis revealed a significant difference in AD \u2265 55 mm (hazard ratio [HR]: 2.88, 95% confidence interval [CI] 1.38\u20136.02, <jats:italic>p<\/jats:italic> &lt; 0.01) and age (HR: 1.09, 95% CI 1.05\u20131.13, <jats:italic>p<\/jats:italic> &lt; 0.01).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Under the existing surgical indication criteria, there was no difference in mortality rates among patients with UTBAD based on their surgical treatment.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0298644","type":"journal-article","created":{"date-parts":[[2024,2,23]],"date-time":"2024-02-23T19:02:32Z","timestamp":1708714952000},"page":"e0298644","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":2,"title":["Surgical treatment in the chronic phase for uncomplicated Stanford type B aortic dissection"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1553-1317","authenticated-orcid":true,"given":"Akihito","family":"Matsushita","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Minoru","family":"Tabata","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takashi","family":"Hattori","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wahei","family":"Mihara","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasunori","family":"Sato","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2024,2,23]]},"reference":[{"key":"pone.0298644.ref001","doi-asserted-by":"crossref","first-page":"1559","DOI":"10.1016\/j.athoracsur.2018.10.045","article-title":"Endovascular versus open repair for chronic type B aortic dissection treatment: a meta-analysis","volume":"107","author":"M Boufi","year":"2019","journal-title":"Ann Thorac Surg"},{"key":"pone.0298644.ref002","doi-asserted-by":"crossref","first-page":"1260","DOI":"10.1016\/j.athoracsur.2014.11.037","article-title":"Propensity adjusted analysis of open and endovascular thoracic aortic repair for chronic type B dissection: a twenty-year evaluation","volume":"99","author":"GH Van Bogerijen","year":"2015","journal-title":"Ann Thorac Surg"},{"key":"pone.0298644.ref003","doi-asserted-by":"crossref","first-page":"904","DOI":"10.1093\/ejcts\/ezz348","article-title":"Follow-up outcomes after the frozen elephant trunk technique in chronic type B dissection","volume":"57","author":"E Charchyan","year":"2020","journal-title":"Eur J Cardiothorac Surg"},{"key":"pone.0298644.ref004","first-page":"103","article-title":"Vascular plug embolization of false lumen for impending rupture in a patient with chronic type B dissecting aortic aneurysm","volume":"27","author":"K Yumoto","year":"2018","journal-title":"Jpn J Vasc Surg"},{"key":"pone.0298644.ref005","doi-asserted-by":"crossref","first-page":"2173","DOI":"10.1016\/j.jtcvs.2019.06.019","article-title":"Risk score system for late aortic events in patients with uncomplicated type B aortic dissection","volume":"159","author":"A Matsushita","year":"2020","journal-title":"J Thorac Cardiovasc Surg"},{"key":"pone.0298644.ref006","doi-asserted-by":"crossref","first-page":"1132","DOI":"10.1093\/icvts\/ivac003","article-title":"False lumen being larger than true lumen is associated with late aortic events in uncomplicated type B aortic dissection","volume":"34","author":"A Matsushita","year":"2022","journal-title":"Interact Cardiovasc Thorac Surg"},{"issue":"41","key":"pone.0298644.ref007","doi-asserted-by":"crossref","first-page":"2873","DOI":"10.1093\/eurheartj\/ehu281","article-title":"2014 ESC guidelines on the diagnosis and treatment of aortic disease: Document covering acute and chronic aortic disease of the thoracic and abdominal aorta of the adult. The Task Force for the Diagnosis and Treatment of Aortic Diseases of the European Society of Cardiology (ESC)","volume":"35","author":"R Erbel","year":"2014","journal-title":"Eur Heart J"},{"key":"pone.0298644.ref008","doi-asserted-by":"crossref","first-page":"S163","DOI":"10.1016\/j.jtcvs.2014.11.028","article-title":"Thoracic endovascular aortic repair versus open surgery for type-B chronic dissection","volume":"149","author":"EE Roselli","year":"2015","journal-title":"J Thorac Cardiovasc Surg"},{"key":"pone.0298644.ref009","doi-asserted-by":"crossref","first-page":"866","DOI":"10.1016\/j.jtcvs.2012.01.021","article-title":"Open repair of chronic distal aortic dissection in the endovascular era: Implications for disease management","volume":"144","author":"AC Pujara","year":"2012","journal-title":"J Thorac Cardiovasc Surg"},{"key":"pone.0298644.ref010","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1016\/j.athoracsur.2017.06.016","article-title":"The impact of thoracic endovascular aortic repair on long-term survival in type B aortic dissection","volume":"105","author":"X Lou","year":"2018","journal-title":"Ann Thorac Surg"},{"key":"pone.0298644.ref011","doi-asserted-by":"crossref","first-page":"794","DOI":"10.1016\/j.ejvs.2019.08.003","article-title":"Endivascular vs. medical management for uncomplicated acute and sub-acute type B aortic dissection: A meta-analysis","volume":"59","author":"M Hossack","year":"2020","journal-title":"Eur J Vasc Endovasc Surg"},{"issue":"1","key":"pone.0298644.ref012","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1001\/jamacardio.2022.4187","article-title":"Initial thoracic endovascular aortic repair vs medical therapy for acute uncomplicated type B aortic dissection","volume":"8","author":"EH Weissler","year":"2023","journal-title":"JAMA Cardiol"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0298644","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,2,23]],"date-time":"2024-02-23T19:02:44Z","timestamp":1708714964000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0298644"}},"subtitle":[],"editor":[{"given":"Alessandro","family":"Leone","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2024,2,23]]},"references-count":12,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2024,2,23]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0298644","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,2,23]]}}}