Vijayvergiya Rajesh, Kumar Basant, Uppal Lipi, Sharma Ashish, Savlania Ajay, Gupta Ankush, Singh Harkant, Singhal Manphool
Post Graduate Institute of Medical Education and Research - PGIMER, Chandigarh, India.
J Vasc Bras. 2025 Jul 30;24:e20240147. doi: 10.1590/1677-5449.202401472. eCollection 2025.
Thoraco-abdominal endovascular aortic repair [(T)EVAR] of thoracic (TEVAR) and abdominal aorta (EVAR) has surpassed open surgical repair for thoraco-abdominal aortic diseases.
We describe the long-term outcomes of 101 (T)EVAR patients treated over the last eleven years.
A retrospective analysis of 101 consecutive (T)EVAR patients was performed. The primary endpoints were in-hospital and 30-day outcomes, while the secondary endpoints were long-term outcomes and re-intervention rates.
Out of 101 patients, EVAR and TEVAR were performed in 40 (39.6%) and 61 (60.3%) patients, respectively. Mean age was 58.04 ± 15.7 years. Technical success rates were 100% and 95% in the EVAR and TEVAR groups, respectively. Intraoperative endoleak was observed in 17 patients. Major perioperative complications (n=16) included retrograde aortic dissection (n=1), stent graft migration (n=2), paraparesis (n=1), device system entrapment in iliac vessels (n=1), acute renal failure (n=2), acute limb ischemia (n=3), and aorto-enteric fistula (n=2). The 30-day mortality rate was 7.9% (8 patients). Kaplan Meyer survival estimates at 1 and 5 years were 79% (95% CI 66.0-87.0, SE 0.053%) and 71% (95%CI 56.0- 81.0, SE 0.065%) for TEVAR and 84% (95% CI 67.0-92.0, SE 0.061%) and 69% (95%CI 46.0-83.0, SE 0.094%) for EVAR, respectively. Diabetes and smoking were associated with increased all-cause mortality in EVAR (p=0.018) and TEVAR (p=0.045) cases, respectively, following Cox regression analysis.
We observed favorable short- and long-term outcomes in 101 (T)EVAR patients, proving its safety and long-term efficacy for management of thoracoabdominal aortic disease.
胸主动脉（TEVAR）和腹主动脉（EVAR）的胸腹主动脉腔内修复术[(T)EVAR]已超过开放性手术修复，用于治疗胸腹主动脉疾病。
我们描述了过去十一年中接受治疗的101例(T)EVAR患者的长期预后情况。
对101例连续的(T)EVAR患者进行回顾性分析。主要终点是住院期间和30天的预后情况，次要终点是长期预后情况和再次干预率。
101例患者中，分别有40例（39.6%）接受了EVAR，61例（60.3%）接受了TEVAR。平均年龄为58.04±15.7岁。EVAR组和TEVAR组的技术成功率分别为100%和95%。17例患者术中观察到内漏。主要围手术期并发症（n = 16）包括逆行性主动脉夹层（n = 1）、支架移植物移位（n = 2）、截瘫（n = 1）、髂血管内装置系统嵌顿（n = 1）、急性肾衰竭（n = 2）、急性肢体缺血（n = 3）和主动脉肠瘘（n = 2）。30天死亡率为7.9%（8例患者）。TEVAR组1年和5年的Kaplan Meyer生存率估计分别为79%（95%CI 66.0 - 87.0，SE 0.053%）和71%（95%CI 56.0 - 81.0，SE 0.065%），EVAR组分别为84%（95%CI 67.0 - 92.0，SE 0.061%）和69%（95%CI 46.0 - 83.0，SE 0.094%）。Cox回归分析后发现，糖尿病和吸烟分别与EVAR（p = 0.018）和TEVAR（p = 0.045）病例的全因死亡率增加相关。
我们观察到101例(T)EVAR患者有良好的短期和长期预后，证明了其治疗胸腹主动脉疾病的安全性和长期疗效。
