Logistic regression-based risk prediction of aortic adverse remodeling following thoracic endovascular aortic repair in patients with aortic dissection

Sep 28, 2026

Uploaded by Sarah

Aortic adverse remodeling remains a critical complication after thoracic endovascular aortic repair (TEVAR) for Stanford type B aortic dissection, with major implications for long-term survival. A retrospective observational cohort study of 140 TEVAR-treated TBAD patients (2019–2024) was used to build and validate a logistic regression model to stratify risk. Multivariable analysis assessed predictors via ROC-AUC and Hosmer-Lemeshow calibration. The model showed excellent discrimination and calibration.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages10

Reading Time25 min

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Abstract

Background

Aim

Methods

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Conclusion

| W | J | C | World Journal of
Cardiology | | --- | --- | --- | --- | Submit a Manuscript: [https://www.f6publishing.com](https://www.f6publishing.com) World J Cardiol 2025 December 26; 17(12): 112978 DOI: 10.4330/wjc.v17.i12.112978 ISSN 1949-8462 (online) ORIGINAL ARTICLE Clinical Trials Study Logistic regression-based risk prediction of aortic adverse remodeling following thoracic endovascular aortic repair in patients with aortic dissection Lian-Feng Wang, Hong-Jiang Zhu, Cong Wang, Feng Yan, Chang-Zhen Qu Specialty type: Cardiac and cardiovascular systems Provenance and peer review: Invited article; Externally peer reviewed. Peer-review model: Single blind Peer-review report’s classification Scientific Quality: Grade B, Grade D, Grade D Novelty: Grade B, Grade C Creativity or Innovation: Grade B, Grade C Scientific Significance: Grade B, Grade D, Grade D P-Reviewer: Byeon H, PhD, Associate Professor, Research Dean, South Korea; Hantash NA, MD, Researcher, Jordan; Sun LJ, MD, PhD, Researcher, China Received: August 12, 2025 Revised: September 10, 2025 Accepted: November 6, 2025 Published online: December 26, 2025 Processing time: 135 Days and 2.2 Hours Lian-Feng Wang, Department of Oncology II, Zhangjiajie People's Hospital, Zhangjiajie 415000, Hunan Province, China Hong-Jiang Zhu, Cong Wang, Feng Yan, Chang-Zhen Qu, Department of Vascular Interventional Surgery, Zhangjiajie People's Hospital, Zhangjiajie 415000, Hunan Province, China Co-first authors: Lian-Feng Wang and Hong-Jiang Zhu. Corresponding author: Hong-Jiang Zhu, MD, Department of Vascular Interventional Surgery, Zhangjiajie People's Hospital, No. 192 Guyong Road, Yongding District, Zhangjiajie 415000, Hunan Province, [China.](China. 13028176178@163.com)[ 13028176178@163.com](China. 13028176178@163.com) Abstract BACKGROUND Aortic adverse remodeling remains a critical complication following thoracic endovascular aortic repair (TEVAR) for Stanford type B aortic dissection (TBAD), significantly impacting long-term survival. Accurate risk prediction is essential for optimized clinical management. AIM To develop and validate a logistic regression-based risk prediction model for aortic adverse remodeling following TEVAR in patients with TBAD. METHODS This retrospective observational cohort study analyzed 140 TBAD patients undergoing TEVAR at a tertiary center (2019–2024) . Based on European guidelines, patients were categorized into adverse remodeling (aortic growth rate > 2.9 mm/year, n = 45) and favorable remodeling groups (n = 95) . Comprehensive variables (clinical/imaging/surgical) were analyzed using multivariable logistic regression to develop a predictive model. Model performance was assessed via receiver operating characteristic-area under the curve (AUC) and Hosmer-Lemeshow tests. RESULTS Multivariable analysis identified several strong independent predictors of negative aortic remodeling. Larger false lumen diameter at the primary entry tear WJC [https://www.wjgnet.com](https://www.wjgnet.com) 1 December 26, 2025 Volume 17 Issue 12 Wang LF et al. Predicting aortic remodeling post-TEVAR [odds ratio (OR): 1.561, 95%CI: 1.197–2.035; P = 0.001] and patency of the false lumen (OR: 5.639, 95%CI: 4.372- 8.181; P = 0.004) were significant risk factors. False lumen involvement extending to the thoracoabdominal aorta was identified as the strongest predictor, significantly increasing the risk of adverse remodeling (OR: 11.751, 95%CI: 9.841-15.612; P = 0.001) . Conversely, false lumen involvement confined to the thoracic aorta demonstrated a significant protective effect (OR: 0.925, 95%CI: 0.614–0.831; P = 0.015) . The prediction model exhibited excellent discrimination (AUC = 0.968) and calibration (Hosmer-Lemeshow P = 0.824) . CONCLUSION This validated risk prediction model identifies aortic adverse remodeling with high accuracy using routinely available clinical parameters. False lu

FAQs

What clinical problem does the study address after TEVAR?

It addresses aortic adverse remodeling following TEVAR in patients with Stanford type B aortic dissection, which significantly affects long-term survival.

How was the risk prediction model developed and evaluated?

A retrospective cohort of 140 patients was analyzed using multivariable logistic regression, with model performance assessed by ROC-AUC and Hosmer-Lemeshow calibration tests.

Which factors were identified as the strongest predictors of adverse remodeling?

Pan-aortic false lumen involvement extending to the thoracoabdominal aorta was reported as the strongest predictor, while false lumen involvement confined to the thoracic aorta showed a protective effect.

Sep 28, 2026

Uploaded by Sarah