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Long-term Outcomes of Intervention between Open Repair and Endovascular Aortic Repair for Descending Aortic Syndrome: A Propensity-Matched Analysis
Joon Yong Cho
Kyungpook National University Hospital
Corresponding Author
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at BMC Surgery.
Background
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.
Methods
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).
Results
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).
Conclusion
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.
Keywords
Descending aorta, endovascular repair, graft replacement, outcomes, reintervention
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Peer Review Timeline
CURRENT STATUS: Published
Published
On 03 Nov, 2020
No community comments so far
Editorial decision: Accept
On 22 Oct, 2020
Review #1 received
Received 06 Oct, 2020
Review #2 received
Received 02 Oct, 2020
Reviewer #2 agreed
On 19 Sep, 2020
Reviewers invited
Invitations sent on 17 Sep, 2020
Reviewer #1 agreed
On 17 Sep, 2020
Editor assigned
On 16 Sep, 2020
Submission checks complete
On 15 Sep, 2020
Editor invited
On 15 Sep, 2020
Version 1
Posted 03 Aug, 2020
No comments provided
Editorial decision: Major revision
On 25 Aug, 2020
Review #2 received
Received 19 Aug, 2020
Review #1 received
Received 19 Aug, 2020
Reviewer #2 agreed
On 03 Aug, 2020
Reviewer #1 agreed
On 01 Aug, 2020
Reviewers invited
Invitations sent on 31 Jul, 2020
Editor assigned
On 22 Jul, 2020
First submitted
On 21 Jul, 2020
Submission checks complete
On 21 Jul, 2020
Editor invited
On 21 Jul, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
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This preprint is under consideration at BMC Surgery. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Long-term Outcomes of Intervention between Open Repair and Endovascular Aortic Repair for Descending Aortic Syndrome: A Propensity-Matched Analysis
Joon Yong Cho
Kyungpook National University Hospital
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
Published
On 03 Nov, 2020
No community comments so far
Editorial decision: Accept
On 22 Oct, 2020
Review #1 received
Received 06 Oct, 2020
Review #2 received
Received 02 Oct, 2020
Reviewer #2 agreed
On 19 Sep, 2020
Reviewers invited
Invitations sent on 17 Sep, 2020
Reviewer #1 agreed
On 17 Sep, 2020
Editor assigned
On 16 Sep, 2020
Submission checks complete
On 15 Sep, 2020
Editor invited
On 15 Sep, 2020
Version 1
Posted 03 Aug, 2020
No comments provided
Editorial decision: Major revision
On 25 Aug, 2020
Review #2 received
Received 19 Aug, 2020
Review #1 received
Received 19 Aug, 2020
Reviewer #2 agreed
On 03 Aug, 2020
Reviewer #1 agreed
On 01 Aug, 2020
Reviewers invited
Invitations sent on 31 Jul, 2020
Editor assigned
On 22 Jul, 2020
First submitted
On 21 Jul, 2020
Submission checks complete
On 21 Jul, 2020
Editor invited
On 21 Jul, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at BMC Surgery.
Background
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.
Methods
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).
Results
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).
Conclusion
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