Fecha de la publicación: 13/03/2020
Autor: Cristina López Espada (1), Jose Patricio Linares Palomino (2), Jose Manuel Domínguez González (3), Elena Iborra Ortega (4), Pascual Lozano Vilardell (5), Teresa Solanich Valldaura (6), Guido Volo Pérez (7), Estrella Blanco Cañibano (8), Andrés Álvarez Salgado (9), Juan Carlos Fernández Fernández (10), Manuel Hernando Rydings (11), Manuel Miralles Hernández (12)
1Vascular Surgery Unit, University Hospital Virgen de las Nieves of Granada, Spain. Electronic address: firstname.lastname@example.org.
2Vascular Surgery Unit, University Hospital Virgen de las Nieves of Granada, Spain.
3Vascular Surgery Unit, University Hospital Vall d’Hebron of Barcelona, Spain.
4Vascular Surgery Unit, University Hospital Bellvitge of Barcelona, Spain.
5Vascular Surgery Unit, University Hospital Son Espases Palma de Mallorca, Spain.
6Vascular Surgery Unit, Corporació Sanitaria Parc Tauli de Sabadell, Spain.
7Vascular Surgery Unit, University Hospital Dr.Negrín de Gran Canaria, Spain.
8Vascular Surgery Unit, University Hospital Guadalajara, Spain.
9Vascular Surgery Unit, University Hospital Cabueñes, Spain.
10Vascular Surgery Unit, Hospital de Galdakao, Spain.
11Vascular Surgery Unit, University Hospital Basurto, Spain.
12Vascular Surgery Unit, University Hospital La Fe Valencia, Spain.
Background: Endovascular techniques have become an essential tool for treatment of thoracic aortic pathology. The objective of this study was to analyze indications and results of thoracic endovascular aortic repair (TEVAR) in vascular surgery units, through a retrospective and multicentric national registry called Regis-TEVAR.
Methods: From 2012 to 2016, a total of 287 patients from 11 vascular surgery units, treated urgently and electively, were recruited consecutively. The primary variables analyzed are mortality, survival, and reintervention rate. The following indications for TEVAR were also analyzed: aortic dissections, thoracic aneurysms, traumatisms, and intramural hematomas or penetrating ulcers, as well as results and postoperative complications in accordance with each indication.
Results: Of the 287 TEVAR performed (239 men, mean age 64.1 ± 14.1 years), 155 were because of aortic aneurysm (54%), 90 because of type B aortic dissection (31.4%), 36 because of traumatic aortic rupture (12.5%), and 6 because of penetrating ulcers or intramural hematomas (2.1%). Overall mortality at 30 days was 11.5% (18.5% in urgent and 5.3% in elective), being higher in dissections (13.3%). The median actuarial survival was 73% at 4 years. The stroke rate was 3.1%, and the rate of spinal cord ischemia was 4.9%. Aortic reoperations were necessary in 23 patients (8.1%).
Conclusions: This registry provides complete and reliable information on real clinical practice of TEVAR in Spain, with results similar to international series of open surgery. In accordance with these data, TEVAR can be performed with acceptable morbidity and mortality and with low rates of postoperative complications.
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