Aljabri Badr, Iqbal Kaisor, Alanezi Tariq, Al-Salman Mussaad, Altuwaijri Talal, Aldossary Mohammed Yousef, Alarify Ghadah A, Alhadlaq Leen S, Alhamlan Sarah A, AlSheikh Sultan, Altoijry Abdulmajeed
Division of Vascular Surgery, Department of Surgery, College of Medicine, King Saud University, Riyadh 11322, Saudi Arabia.
College of Medicine, King Saud University, Riyadh 11322, Saudi Arabia.
J Clin Med. 2024 Sep 13;13(18):5450. doi: 10.3390/jcm13185450.
: Since thoracic endovascular aortic repair (TEVAR) and endovascular aneurysm repair (EVAR) are increasingly utilized, examining their outcomes and safety in real-world scenarios is crucial. This study investigated the management and outcomes of TEVAR and EVAR as alternatives to traditional open surgical repair for managing aortic pathologies. : This was a retrospective cohort study. We analyzed the data from 59 consecutive patients who underwent TEVAR or EVAR between 2015 and 2022 at a single tertiary care center. The primary outcome was survival, and secondary outcomes were complications assessment, including re-intervention and occurrence of endoleaks. : TEVAR accounted for 47.5% of cases (n = 28), while EVAR comprised 52.5% (n = 31). Patients were mostly 61-70 years old (23.7%) and male (91.5%). Surgery indications differed, with aneurysmal repair being the prevalent indication for EVAR (90.3%, n = 28) and trauma being the main indication for TEVAR (67.9%, n = 19). Regarding the primary outcome, 11 patients (18.6%) died for various reasons; of those, 2 patients (3.4%) were determined to have died from vascular-related issues. Most patients (81.4%, n = 48) did not experience intraoperative complications. The most common intraoperative complications were endoleaks and access failure, each affecting 5.1% (n = 3) of patients. Re-intervention was necessary in 16.9% (n = 10) of cases, with endoleaks being the major indication (60%). Emergency intervention was more frequent in the TEVAR group = 0.013), resulting in significantly longer hospitalization ( = 0.012). : Despite limitations, our analysis indicates a good safety profile with high success rates and a low incidence of adverse health outcomes and mortality in TEVAR/EVAR procedures. Nevertheless, the results emphasize the ongoing concern of endograft leaks, necessitating re-interventions.
由于胸主动脉腔内修复术(TEVAR)和腹主动脉瘤腔内修复术(EVAR)的应用越来越广泛,在现实场景中检查它们的疗效和安全性至关重要。本研究调查了TEVAR和EVAR作为传统开放手术修复主动脉病变替代方法的管理情况和疗效。
这是一项回顾性队列研究。我们分析了2015年至2022年期间在一家三级医疗中心连续接受TEVAR或EVAR治疗的59例患者的数据。主要结局是生存情况,次要结局是并发症评估,包括再次干预和内漏的发生情况。
TEVAR占病例的47.5%(n = 28),而EVAR占52.5%(n = 31)。患者大多为61 - 70岁(23.7%),男性占91.5%。手术指征不同,动脉瘤修复是EVAR的主要指征(90.3%,n = 28),而创伤是TEVAR的主要指征(67.9%,n = 19)。关于主要结局,11例患者(18.6%)因各种原因死亡;其中,2例患者(3.4%)被确定死于血管相关问题。大多数患者(81.4%,n = 48)未发生术中并发症。最常见的术中并发症是内漏和入路失败,各影响5.1%(n = 3)的患者。16.9%(n = 10)的病例需要再次干预,内漏是主要指征(60%)。TEVAR组的急诊干预更频繁(P = 0.013),导致住院时间显著延长(P = 0.012)。
尽管存在局限性,但我们的分析表明,TEVAR/EVAR手术具有良好的安全性,成功率高,不良健康结局和死亡率发生率低。然而,结果强调了对移植物内漏持续存在的担忧,需要再次干预。