To further assess the early and mid-term outcomes of thoracic endovascular aortic repair (TEVAR) in patients with acute uncomplicated type B aortic dissection (TBAD) compared with those receiving best medical treatment (BMT). Between February 2008 and March 2018, 357 consecutive patients with acute uncomplicated TBAD were retrospectively analyzed. Among them, 191 patients underwent TEVAR, and 166 received BMT. After propensity score matching, we obtained 145 matched pairs for analysis. In the matched population, the 30-day mortality between the TEVAR group and the BMT group showed no statistically significant difference, whereas the early adverse events rates in the TEVAR group were significantly greater than that of the BMT group (P = .003). Freedom from all-cause mortality in the TEVAR group was significantly greater than that of the BMT group (TEVAR: 91.9% at 5 years, BMT: 82.2% at 5 years, P = .028). Freedom from aortic-related mortality in the TEVAR group was significantly greater than that of the BMT group (TEVAR: 94.1% at 5 years, BMT: 86.1% at 5 years, P = .044). Multivariable Cox-hazard regression analysis demonstrated that the older age (hazard ratio [HR], 1.04; 95% confidence interval [CI], 1.01-1.08, P = .013), BMT (HR, 2.33; 95% CI, 1.08-5.05, P = .032), and the distance between the primary entry tear and the left subclavian artery <2.0 cm (HR, 2.30; 95% CI, 1.06-4.99, P = .035) were the significant risk factors for all-cause death. Given death as a competing factor, the cumulative incidence of rupture in the BMT group was significantly greater than that of the TEVAR group (BMT: 13.7% at 5 years, TEVAR: 5.1% at 5 years, P = .024). Despite more complications in the early stage, TEVAR was associated with decreased risk of late death and had fewer late aortic ruptures compared with BMT in patients with acute uncomplicated TBAD. Therefore, TEVAR may be considered as the first option to improve the late outcomes in these patients.

This study aimed to investigate the diagnostic and evaluative significance of combining median nerve (MN) morphological measurements with diffusion tensor imaging (DTI) and T2 mapping metrics for carpal tunnel syndrome (CTS). Morphological and multiparametric magnetic resonance neurography (MRN), along with clinical evaluation, were conducted on 33 CTS patients and 32 healthy controls. The MRN metrics included fractional anisotropy (FA), apparent diffusion coefficient (ADC), axial diffusivity (AD), radial diffusivity (RD), T2 value, cross-sectional area (CSA) and MN flattening ratio (MNFR) at both the pisiform bone and hamate bone levels. Differences in MRN metrics between the above two levels (Delta FA, Delta ADC, Delta AD, Delta RD and Delta T2) were calculated. T-tests, multivariable regression, and receiver operating characteristic (ROC) curve analyses were used to compare and classify patients with CTS and controls. The correlations between MRN metrics and clinical characteristics were analyzed. Comparisons were also made between MRN metrics in patients with and without significant symptom improvement after treatment. FA, AD, T2 value, and CSA at the pisiform bone level were identified as independent predictors of CTS. The combination of these metrics improved diagnostic performance (AUC 0.922, sensitivity 84.85% and specificity 90.62%). Delta ADC, Delta AD, and Delta T2 correlated with function Boston scores. The T2 value at hamate bone level, along with Delta AD and FA, correlated with visual analogue score (VAS). CSA and Delta T2 had higher AUCs for classifying patients with and without significant symptom improvement after treatment. These findings suggest that combining MN morphological and multiparametric MRN metrics can enhance the diagnostic performance of CTS and has the potential to provide an objective and quantitative basis for further study of the degree of entrapment and prognosis.