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Article ; Online: Five-Year Survival and Complications of Thoracic Endovascular Aortic Repair (TEVAR): A Single Tertiary Center Registry for All-Comers Patients.

Haji-Zeinali, Ali Mohammad / Mansouri, Pejman / Raeis Hosseini, Neda / Abbasi, Kiomars / Shirzad, Mahamoud / Jameie, Mana / Haji-Zeinali, Mohammad Mohsen

Cardiovascular revascularization medicine : including molecular interventions

2023  Volume 51, Page(s) 23–30

Abstract: Introduction: Studies on the mid and long-term outcomes of thoracic endovascular aortic repair (TEVAR) are scarce. This study aimed to investigate the long-term outcomes of TEVAR for all-comers patients with various types of thoracic aortic pathologies, ...

Abstract Introduction: Studies on the mid and long-term outcomes of thoracic endovascular aortic repair (TEVAR) are scarce. This study aimed to investigate the long-term outcomes of TEVAR for all-comers patients with various types of thoracic aortic pathologies, predominantly thoracic aortic dissections and thoracic aortic aneurysms.
Methods: Between January 2005 and December 2015, 123 consecutive patients with thoracic aortic pathologies underwent TEVAR. The patients were divided into groups based on aortic pathologies (dissections or aneurysms) and the type of procedure (hybrid TEVAR or non-hybrid TEVAR). Mortality, complications, and reintervention rates were compared between these four groups. The Kaplan-Meier curve and the Cox regression analysis were employed to estimate survivals and factors associated with 5-year mortality.
Results: One hundred twenty-three consecutive patients with various aortic pathologies undergoing TEVAR were evaluated. Hypertension (79.7 %) and smoking (39 %) were the most common comorbidities in the study population. The patients were followed up for a mean duration of 58.1 ± 7.1 months to evaluate the postprocedural surveillance. Most complications occurred in the dissection and hybrid groups; however, these differences were nonsignificant. The overall 5-year surveillance and reintervention rates were 65 % and 12.1 %, respectively. A significant difference existed in 5-year survival between the patients with aneurysmal and aortic dissection pathologies based on the log-rank test (P = 0.01). On the other hand, no significant differences were observed in 5-year survival between the patients who underwent hybrid and non-hybrid TEVAR. The Cox regression analysis confirmed that chronic kidney disease, previous coronary artery bypass grafting, age >65 years, platelet counts <150∗ 10
Conclusions: The long-term outcomes of TEVAR for various aortic pathologies disclosed that this procedure was well-tolerated in a group of patients with high comorbid conditions. The five-year survival rate of TEVAR for thoracic aortic dissections was more favorable than that for thoracic aortic aneurysms, but there were no significant differences between hybrid and non-hybrid procedures regarding the mortality rate.
MeSH term(s) Humans ; Aged ; Endovascular Aneurysm Repair ; Blood Vessel Prosthesis Implantation/adverse effects ; Treatment Outcome ; Endovascular Procedures/adverse effects ; Risk Factors ; Aortic Aneurysm, Thoracic/diagnostic imaging ; Aortic Aneurysm, Thoracic/surgery ; Aortic Aneurysm, Thoracic/etiology ; Aortic Dissection/diagnostic imaging ; Aortic Dissection/surgery ; Registries
Language English
Publishing date 2023-01-30
Publishing country United States
Document type Journal Article
ZDB-ID 2212113-4
ISSN 1878-0938 ; 1553-8389
ISSN (online) 1878-0938
ISSN 1553-8389
DOI 10.1016/j.carrev.2023.01.020
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