Endovascular Treatment of Descending Thoracic Aortic Pathology: Results of the Regis-TEVAR Study

• Published in: Annals of vascular surgery Vol. 67; pp. 306 - 315
• Main Authors: López Espada, Cristina, Linares Palomino, Jose Patricio, Domínguez González, Jose Manuel, Iborra Ortega, Elena, Lozano Vilardell, Pascual, Solanich Valldaura, Teresa, Volo Pérez, Guido, Blanco Cañibano, Estrella, Álvarez Salgado, Andrés, Fernández Fernández, Juan Carlos, Hernando Rydings, Manuel, Miralles Hernández, Manuel
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Inc 01.08.2020
• ISSN: 0890-5096; 1615-5947
• DOI: 10.1016/j.avsg.2020.02.012

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. 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. 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%). 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. •The first Spanish multicenter registry on endovascular treatment of thoracic aortic disease.•Reliable information on real-world clinical practice of TEVAR.•Indication distribution: 54% thoracic aortic aneurysm, 31.4% type B aortic dissections, and 12.5% traumatic aortic injuries.•The overall mortality was 11.9%, higher (18.5%) if the repair was urgent.•Low-stroke rate (3.1%) and spinal cord ischemia (4.9%).•TEVAR can be performed with acceptable morbidity and mortality and with low rates of postoperative complications.