Sex-related Outcomes After Thoracic Endovascular Repair for Intact Isolated Descending Thoracic Aortic Aneurysm: A Retrospective Cohort Study.

Autor:	Allievi S; Department of Surgery, Division of Vascular and Endovascular Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.; Section of Vascular Surgery, Cardio Thoracic Vascular Department, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy, Milan, Italy., Rastogi V; Department of Surgery, Division of Vascular and Endovascular Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.; Department of Vascular Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands., Yadavalli SD; Department of Surgery, Division of Vascular and Endovascular Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA., Mandigers TJ; Department of Surgery, Division of Vascular and Endovascular Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.; Section of Vascular Surgery, Cardio Thoracic Vascular Department, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy, Milan, Italy.; Department of Vascular Surgery, University Medical Center Utrecht, Utrecht, The Netherlands., Gomez-Mayorga JL; Department of Surgery, Division of Vascular and Endovascular Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA., Deery SE; Division of Vascular Surgery, Maine Medical Center, Portland, ME., Lo RC; Department of Surgery, Division of Vascular Surgery, Rhode Island Hospital, Alpert Medical School of Brown University, Providence, RI., Verhagen HJM; Department of Vascular Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands., Trimarchi S; Section of Vascular Surgery, Cardio Thoracic Vascular Department, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy, Milan, Italy.; Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy., Schermerhorn ML; Department of Surgery, Division of Vascular and Endovascular Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.
Jazyk:	angličtina
Zdroj:	Annals of surgery [Ann Surg] 2024 Jul 01; Vol. 280 (1), pp. 165-172. Date of Electronic Publication: 2023 Dec 04.
DOI:	10.1097/SLA.0000000000006163
Abstrakt:	Objective: The aim of this study was to evaluate the association between sex and outcomes following thoracic endovascular aortic repair (TEVAR) for intact isolated descending thoracic aortic aneurysms (iiDTAA). Background: Data regarding sex-related long-term outcomes after TEVAR for iiDTAA are limited and conflicting results regarding perioperative outcomes have been reported. Methods: We included all TEVAR for iiDTAA between 2014 and 2019 in the Vascular Quality Initiative linked to Medicare claims, allowing reliable assessment of long-term outcome data. Primary outcomes included 5-year mortality, reinterventions, and ruptures of the thoracic aorta. Secondarily, we assessed perioperative outcomes. Results: We identified 685 patients, of which 54% were females. Females had higher aortic size index {females vs males: 3.31 [interquartile range (IQR), 2.81-3.85] cm/m 2 vs 2.93 (IQR, 2.42-3.36) cm/m 2 ; P <0.001}, were more frequently symptomatic (31% vs 20%; P =0.001), had longer procedure time [111 (IQR, 72-165) minutes vs 97 (IQR, 70-146) minutes] and more iliac procedures (16% vs 7.6%; P =0.001). Compared with males, females had similar rates of 5-year mortality [58% vs 53%; hazard ratio (HR), 0.93; 95% CI: 0.71-1.22; P =0.61), reinterventions (39% vs 30%; HR, 1.12; 95% CI: 0.73-1.73; P =0.60), and late ruptures (0.6% vs 1.2%; HR, 0.87; 95% CI: 0.12-6.18; P =0.89). After adjustment, these outcomes remained similar through 5 years. Furthermore, perioperative mortality was not significantly different between sexes (4.1% vs 2.2%; P =0.25), as were rates of any complication as a composite outcome (16% vs 21%; P =0.16), as well as of individual complications (all P >0.05). Conclusion: Our findings suggest that females who undergo TEVAR for iiDTAA have similar 5-year and perioperative outcomes as compared with males. Competing Interests: H.J.M.V. is a consultant of Medtronic, WL Gore, Terumo, Atrivion, Endologix, Philips. S.T. is a consultant for Terumo, Medtronic, and WL Gore. The remaining authors report no conflicts of interest. (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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