Long-term Outcomes of Intervention between Open Repair and Endovascular Aortic Repair for Descending Aortic Syndrome: A Propensity-Matched Analysis
The long-term complication rates of open repair and thoracic endovascular aortic repair (TEVAR) have not yet been determined. Therefore, this study aimed to compare long-term outcomes and aortic reintervention rates between open repair and TEVAR in patients with descending thoracic aortic diseases.
Between January 2002 and December 2017, 230 patients with descending thoracic aortic disease underwent surgery. Among them, 45 patients underwent open repair and 91 underwent TEVAR treatment at Kyungpook National University Hospital. The primary end points were in-hospital mortality, and short-term complications. The secondary end points were long-term mortality and reintervention rates. Based on the propensity score matching, 35 patients who underwent open repair were matched to 35 patients who underwent TEVAR (ratio = 1:1).
The mean follow-up period was 70.2 ± 51.9 months. Shorter intensive care unit and hospital stay were seen in the TEVAR group than in the open repair group (p < 0.001 and p < 0.001, respectively). However, in-hospital mortality, and spinal cord ischemia were not significantly different among the two groups (p = 0.068 and p = 0.211 before matching, p = 0.303 and p = 0.314 after matching, respectively). The cumulative all-cause death and aorta-related death showed no significant difference (p = 0.709 and p = 0.734 before matching, p = 0.888 and p = 0.731 after matching, respectively). However, aortic reintervention rates were higher in the TEVAR group than in the open repair group before and after propensity score matching (p = 0.006 and p = 0.013, respectively).
The TEVAR group was superior in short-term recovery results but had higher reintervention rates compared to the open repair group. However, there was no significant differences between the groups in long-term survival.
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On 03 Nov, 2020
On 22 Oct, 2020
Received 06 Oct, 2020
Received 02 Oct, 2020
On 19 Sep, 2020
Invitations sent on 17 Sep, 2020
On 17 Sep, 2020
On 16 Sep, 2020
On 15 Sep, 2020
On 15 Sep, 2020
Posted 03 Aug, 2020
On 25 Aug, 2020
Received 19 Aug, 2020
Received 19 Aug, 2020
On 03 Aug, 2020
On 01 Aug, 2020
Invitations sent on 31 Jul, 2020
On 22 Jul, 2020
On 21 Jul, 2020
On 21 Jul, 2020
On 21 Jul, 2020
Long-term Outcomes of Intervention between Open Repair and Endovascular Aortic Repair for Descending Aortic Syndrome: A Propensity-Matched Analysis
On 03 Nov, 2020
On 22 Oct, 2020
Received 06 Oct, 2020
Received 02 Oct, 2020
On 19 Sep, 2020
Invitations sent on 17 Sep, 2020
On 17 Sep, 2020
On 16 Sep, 2020
On 15 Sep, 2020
On 15 Sep, 2020
Posted 03 Aug, 2020
On 25 Aug, 2020
Received 19 Aug, 2020
Received 19 Aug, 2020
On 03 Aug, 2020
On 01 Aug, 2020
Invitations sent on 31 Jul, 2020
On 22 Jul, 2020
On 21 Jul, 2020
On 21 Jul, 2020
On 21 Jul, 2020
The long-term complication rates of open repair and thoracic endovascular aortic repair (TEVAR) have not yet been determined. Therefore, this study aimed to compare long-term outcomes and aortic reintervention rates between open repair and TEVAR in patients with descending thoracic aortic diseases.
Between January 2002 and December 2017, 230 patients with descending thoracic aortic disease underwent surgery. Among them, 45 patients underwent open repair and 91 underwent TEVAR treatment at Kyungpook National University Hospital. The primary end points were in-hospital mortality, and short-term complications. The secondary end points were long-term mortality and reintervention rates. Based on the propensity score matching, 35 patients who underwent open repair were matched to 35 patients who underwent TEVAR (ratio = 1:1).
The mean follow-up period was 70.2 ± 51.9 months. Shorter intensive care unit and hospital stay were seen in the TEVAR group than in the open repair group (p < 0.001 and p < 0.001, respectively). However, in-hospital mortality, and spinal cord ischemia were not significantly different among the two groups (p = 0.068 and p = 0.211 before matching, p = 0.303 and p = 0.314 after matching, respectively). The cumulative all-cause death and aorta-related death showed no significant difference (p = 0.709 and p = 0.734 before matching, p = 0.888 and p = 0.731 after matching, respectively). However, aortic reintervention rates were higher in the TEVAR group than in the open repair group before and after propensity score matching (p = 0.006 and p = 0.013, respectively).
The TEVAR group was superior in short-term recovery results but had higher reintervention rates compared to the open repair group. However, there was no significant differences between the groups in long-term survival.
Figure 1
Figure 2
Figure 3
Figure 4