Endovascular repair in patients with aortic dissection and aortic aneurysm: A retrospective cohort study.

Abstract

Abstract Background Therapeutic options in patients with aortic diseases include medical treatment, surgical and percutaneous intervention. The latter has been proved to be safe in patients with aortic aneurysm (AA) and aortic dissection (AD), but still represents challenging and with significant mortality rates. For these reasons, we aimed to compare procedural and in-hospital complications in patients with AA and AD treated with transfemoral transcatheter endovascular aortic repair (EVAR). Methods Patients treated using transfemoral EVAR from 2012 to 2017 at the Hospital de Cardiología, Centro Médico Nacional Siglo XXI, Mexico City with complete computed tomography (CT) and diagnostic of AA and AD were included. Procedural and in-hospital related complications were compared among patients treated due to AA and AD. Endpoints of the study were in-hospital and thirty days all-cause mortality and any cause of readmission. Results A total of 38 patients with high quality CT were included in the analysis. From them, 25 had AA and 13 AD. Mean age was 64 ± 14 yeas, 23.7% were females. Urgent treatment was required in 31.6%, the number of prosthesis used was 2.13 [1, 5] per patients. No in-hospital mortality was observed. Type 1a endoleak was similar in both groups (AA 8% vs. AD 15.4%, p = 0.59). Conversion to surgery was needed only in one patient (AA 4% vs AD 0%, p > 0.99). No difference was observed regarding endovascular reintervention (16% vs. 15.4%, p > 0.99), graft thrombosis (12% vs. 0%, p = 0.53), spinal cord injury (0% vs. 15.4%, p = 0.11) or vascular complication (8% vs. 15.4%, p = 0.59%) between AA and AD respectively. No 30-days mortality was observed. Conclusions EVAR represents a safe procedure in patients presenting with AA or AD, with no in-hospital or 30 days mortality rate and very low reintervention rate.