Endovascular Repair versus Open Repair for Isolated Descending Thoracic Aortic Aneurysm.
10.3349/ymj.2015.56.4.904
- Author:
Hyung Chae LEE
1
;
Hyun Chel JOO
;
Seung Hyun LEE
;
Sak LEE
;
Byung Chul CHANG
;
Kyung Jong YOO
;
Young Nam YOUN
Author Information
1. Division of Cardiovascular Surgery, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Yonsei University Health System, Seoul, Korea. ynyoun@yuhs.ac
- Publication Type:Original Article
- Keywords:
Aortic aneurysm;
aorta;
descending;
endovascular procedures;
cardiovascular surgical procedures;
outcome assessment
- MeSH:
Age Factors;
Aged;
Aneurysm, Dissecting/*epidemiology/surgery;
Aortic Aneurysm, Thoracic/mortality/*surgery;
Aortic Rupture/mortality/*surgery;
Blood Vessel Prosthesis Implantation;
Endovascular Procedures;
Female;
Humans;
Incidence;
Male;
Middle Aged;
Republic of Korea;
Stroke/etiology;
Survival Rate;
Time Factors;
Treatment Outcome
- From:Yonsei Medical Journal
2015;56(4):904-912
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: To compare the outcomes of thoracic endovascular aortic repair (TEVAR) with those of open repair for descending thoracic aortic aneurysms (DTAA). MATERIALS AND METHODS: We compared the outcomes of 114 patients with DTAA and proximal landing zones 3 or 4 after TEVAR to those of 53 patients after conventional open repairs. Thirty-day and late mortality were the primary endpoints, and early morbidities, aneurysm-related death, and re-intervention were the secondary endpoints. RESULTS: The TEVAR group was older and had more incidences of dissecting aneurysm. The mean follow-up was 36+/-26 months (follow-up rate, 97.8%). The 30-day mortality in the TEVAR and open repair groups were 3.5% and 9.4% (p=0.11). Perioperative stroke and paraplegia incidences were similar between the groups [5.3% vs. 7.5% (p=0.56) and 7.5% vs. 3.5% (p=0.26), respectively]. Respiratory failure occurred more in the open repair group (1.8% vs. 26.4%, p<0.01). The incidence of acute kidney injury requiring dialysis was higher in the open repair group (1.8% vs. 9.4%, p<0.01). The cumulative survival rate was higher in the TEVAR group at 2 to 5 years (79.6% vs. 58.3%, p=0.03). The free from re-intervention was lower in the TEVAR group (65.3% vs. 100%, p=0.02), and the free from aneurysm-related death in the TEVAR and open repair groups were 88.5% and 86.1% (p=0.45). CONCLUSION: TEVAR is safe and effective for treating DTAAs with improved perioperative and long-term outcomes compared with open repair.
