Nana Petroula, Jama Katarzyna, Kölbel Tilo, Spanos Konstantinos, Panuccio Giuseppe, Jakimowicz Tomasz, Rohlffs Fiona
German Aortic Center, Department of Vascular Medicine, University Heart and Vascular Center, University Medical Center Eppendorf, 20251 Hamburg, Germany.
Department of General, Vascular and Transplant Surgery, Medical University of Warsaw, 02-006 Warsaw, Poland.
J Clin Med. 2023 Sep 7;12(18):5811. doi: 10.3390/jcm12185811.
Females are at increased risk of mortality compared to males after complex endovascular aortic repair. This study aims to examine sex-related peri-operative and follow-up outcomes in patients managed with the t-Branch device.
A two-center retrospective analysis of patients managed with the off-the-shelf t-Branch device (Cook Medical Inc., Bjaeverskov, Denmark) between 1 January 2014 and 30 September 2020 was performed. Primary outcomes were sex-comparative 30-day mortality, major adverse events (MAEs) and spinal cord ischemia (SCI).
A total of 542 patients were included; 28.0% were females. Urgent repair and type I-III thoracoabdominal aneurysms were more common among females (52.6% vs. 34%, = 0.01, and 57.1% vs. 35.8%, = 0.004). Technical success was similar (97.4% vs. 96.9%, = 0.755), as well as early mortality (16.2% in females vs. 10.8% in males; = 0.084). SCI rates were similar between groups (13.6% vs. 9.2% = 0.183). MAEs were more common in females; 33.7% vs. 21.4% ( = 0.022). Multivariate analysis did not identify sex as an independent predictor of adverse events. The 12-month survival rate was 75.7% (SE 0.045) for females and 84.1% (SE 0.026) for males (log rank, = 0.10).
Sex was not detected as an independent factor of mortality, MAEs and SCI within patients managed with the t-Branch device. Feasibility was high in both groups. No significant difference was shown in survival during the 12-month follow-up.
与男性相比，复杂的血管腔内主动脉修复术后女性的死亡风险更高。本研究旨在探讨使用t-Branch装置治疗的患者与性别相关的围手术期和随访结果。
对2014年1月1日至2020年9月30日期间使用现成的t-Branch装置（丹麦比耶沃斯科夫库克医疗公司）治疗的患者进行了一项双中心回顾性分析。主要结局为性别比较的30天死亡率、主要不良事件（MAE）和脊髓缺血（SCI）。
共纳入542例患者；28.0%为女性。女性中急诊修复和I-III型胸腹主动脉瘤更为常见（分别为52.6%对34%，P = 0.01；57.1%对35.8%，P = 0.004）。技术成功率相似（97.4%对96.9%，P = 0.755），早期死亡率也相似（女性为16.2%，男性为10.8%；P = 0.084）。两组间SCI发生率相似（13.6%对9.2%，P = 0.183）。MAE在女性中更为常见；分别为33.7%对21.4%（P = 0.022）。多变量分析未将性别确定为不良事件的独立预测因素。女性的12个月生存率为75.7%（标准误0.045），男性为84.1%（标准误0.026）（对数秩检验，P = 0.10）。
在使用t-Branch装置治疗的患者中，未发现性别是死亡率、MAE和SCI的独立因素。两组的可行性都很高。在12个月的随访期间，生存率无显著差异。
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