A multicenter study of emergency endovascular repair of the thoracic aorta: indications and outcomes

Autor: P. Lozano Vilardell, A. Álvarez Salgado, C. López Espada, E. Iborra Ortega, M. Hernando Rydings, E. Blanco Cañibano, J.M. Domínguez González, T. Solanich Valldaura, G. Volo Pérez, J.C. Fernández Fernández, M. Miralles Hernández, J.P. Linares Palomino
Rok vydání: 2020
Předmět:
Adult
Male
Traumatic aortic rupture
medicine.medical_specialty
medicine.medical_treatment
Endovascular aneurysm repair
Blood Vessel Prosthesis Implantation
03 medical and health sciences
Aortic aneurysm
0302 clinical medicine
medicine.artery
medicine
Humans
Thoracic aorta
cardiovascular diseases
Elective surgery
Aged
Retrospective Studies
Aortic dissection
Aortic Aneurysm
Thoracic
business.industry
Mortality rate
Endovascular Procedures
030208 emergency & critical care medicine
Middle Aged
Aneurisma aórtico
Aortic aneurysm
Aortic dissection
Disección aórtica
Emergency endovascular repair
Endograft
Endoprótesis
Enfermedades de aorta torácica
Mortalidad
Mortality
Reparación endovascular urgente
Thoracic aortic disease
Traumatic aortic rupture
Traumatismo aórtico
medicine.disease
Surgery
Treatment Outcome
surgical procedures
operative
030228 respiratory system
cardiovascular system
business
Paraplegia
Aortic Aneurysm
Abdominal
Zdroj: MEDICINA INTENSIVA
r-IIS La Fe. Repositorio Institucional de Producción Científica del Instituto de Investigación Sanitaria La Fe
instname
ISSN: 0210-5691
Popis: Objective Endovascular techniques have become an essential tool for the treatment of descending thoracic aortic disease (thoracic endovascular aneurysm repair [TEVAR]). The aim is to analyze the indications and outcomes of emergency TEVAR at national level in relation to elective surgery. Study design and scope A retrospective multicenter registry of patients with descending thoracic aortic disease treated on an emergency basis using endovascular techniques between 2012–2016, in 11 clinical units. Patients, inclusion criteria 1) Ruptured descending thoracic aortic aneurysms (RTAA); 2) Blunt traumatic thoracic aortic injury (TAI); and 3) Complicated acute type B aortic dissections (TBADc). Primary variables Patient mortality, survival and reoperation rate. Secondary variables Demographic data, cardiovascular risk factors, specific data by indication, technical resources and postoperative complications. Results A total of 135 urgent TEVARs were included (111 men, mean age 60.4 ± 16.3 years): 43 ruptured thoracic aortic aneurysms (31.9%), 54 type B dissections (40%) and 32 traumatic aortic injuries (23.7%), and other etiologies 4.4%. The overall mortality rate at 30 days was 18.5%, and proved higher in the RTAA group (27.9%). The mean actuarial survival rate was 67 ± 6% at 5 years. The postoperative stroke rate was 5.2%, and the paraplegia rate was 5.9%. Aortic reoperations proved necessary in 12 patients (9%). Conclusions Emergency descending thoracic aortic diseases can be treated by endovascular techniques with optimal results and low morbidity and mortality — though the figures are slightly higher than in elective cases. This registry provides, for the first time, real information on the daily clinical practice of emergency TEVAR in Spain.
Databáze: OpenAIRE
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