Outcomes of Elective and Non-elective Fenestrated-branched Endovascular Aortic Repair for Treatment of Thoracoabdominal Aortic Aneurysms

• Type: Article in International Conference Proceedings Book
• Date: 2023

Authors

Dias-Neto M (Author) FMUP; Vacirca, A (Author) Other; Huang, Y (Author) Other; Baghbani Oskouei, A (Author) Other; Jakimowicz, T (Author) Other; Mendes, BC (Author) Other; Kolbel, T (Author) Other; Sobocinski, J (Author) Other; Bertoglio, L (Author) Other; Mees, B (Author) Other; Gargiulo, M (Author) Other; Dias, N (Author) Other; Schanzer, A (Author) Other; Gasper, W (Author) Other; Beck, AW (Author) Other; Farber, MA (Author) Other; Mani, K (Author) Other; Timaran, C (Author) Other; Schneider, DB (Author) Other; Pedro, LM (Author) Other; Tsilimparis, N (Author) Other; Haulon, S (Author) Other; Sweet, MP (Author) Other; Ferreira, E (Author) Other; Eagleton, M (Author) Other; Yeung, KK (Author) Other; Khashram, M (Author) Other; Jama, K (Author) Other; Panuccio, G (Author) Other; Rohlffs, F (Author) Other; Mesnard, T (Author) Other; Chiesa, R (Author) Other; Kahlberg, A (Author) Other; Schurink, GW (Author) Other; Lemmens, C (Author) Other; Gallitto, E (Author) Other; Faggioli, G (Author) Other; Karelis, A (Author) Other; Parodi, E (Author) Other; Gomes, V (Author) Other; Wanhainen, A (Author) Other; Habib, M (Author) Other; Colon, JP (Author) Other; Pavarino, F (Author) Other; Baig, MS (Author) Other; Melo, RECD (Author) Other; Crawford, S (Author) Other; Zettervall, SL (Author) Other; Garcia, R (Author) Other; Ribeiro, T (Author) Other; Alves, G (Author) Other; Goncalves, FB (Author) Other; Kappe, KO (Author) Other; van Knippenberg, SEM (Author) Other; Tran, BL (Author) Other; Gormley, S (Author) Other; Oderich, GS (Author) Other; Int Multictr Aort Res Grp (Author) Other

Conference proceedings International

Title: ANNALS OF SURGERY

Pages: 568-577

143rd Annual Meeting of the American-Surgical-Association (ASA)

Toronto, CANADA, APR 20-22, 2023

Indexing

ISI Web of Knowledge - 5 Citations

Scopus - 7 Citations

Other information

Authenticus ID: P-00Z-76G

DOI: 10.1097/sla.0000000000005986

Abstract (EN): Objective: To describe outcomes after elective and non-elective fenestrated-branched endovascular aortic repair (FB-EVAR) for thoracoabdominal aortic aneurysms (TAAAs). Background: FB-EVAR has been increasingly utilized to treat TAAAs; however, outcomes after non-elective versus elective repair are not well described. Methods: Clinical data of consecutive patients undergoing FB-EVAR for TAAAs at 24 centers (2006-2021) were reviewed. Endpoints including early mortality and major adverse events (MAEs), all-cause mortality, and aortic-related mortality (ARM), were analyzed and compared in patients who had non-elective versus elective repair. Results: A total of 2603 patients (69% males; mean age 72 +/- 10 year old) underwent FB-EVAR for TAAAs. Elective repair was performed in 2187 patients (84%) and non-elective repair in 416 patients [16%; 268 (64%) symptomatic, 148 (36%) ruptured]. Non-elective FB-EVAR was associated with higher early mortality (17% vs 5%, P < 0.001) and rates of MAEs (34% vs 20%, P < 0.001). Median follow-up was 15 months ( interquartile range, 7-37 months). Survival and cumulative incidence of ARM at 3 years were both lower for non-elective versus elective patients (50 +/- 4% vs 70 +/- 1% and 21 +/- 3% vs 7 +/- 1%, P < 0.001). On multivariable analysis, non-elective repair was associated with increased risk of all-cause mortality ( hazard ratio, 1.92; 95% CI] 1.50-2.44; P < 0.001) and ARM (hazard ratio, 2.43; 95% CI, 1.63-3.62; P < 0.001). Conclusions: Non-elective FB-EVAR of symptomatic or ruptured TAAAs is feasible, but carries higher incidence of early MAEs and increased all-cause mortality and ARM than elective repair. Long-term follow-up is warranted to justify the treatment.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 10