TEVAR in a Tertiary Vascular Center in the UK: 12-Year Experience and Outcomes

Purpose: Thoracic Endovascular Aneurysm Repair (TEVAR) is a well-established procedure for thoracic aortic pathology including dissections, aneurysms and blunt injuries. Our aims were to evaluate our experience with TEVAR in a tertiary vascular center in the UK in terms of outcomes including safety, effectiveness and durability.

Materials and Methods: Retrospective single-center review of all patients who underwent TEVAR in our tertiary vascular center over 12 years from 2011 to 2023.

Results: A total of 67 patients were identified. Mean age was 68 years (range 31–90). Indications for treatment were aneurysm (39, 56%), dissection (12, 16%), blunt thoracic aortic injuries (6, 9%) and others including penetrating atheromatous ulcers and intramural hematoma (10, 19%). 30 (45%) cases were performed electively. Five cases were performed percutaneously. Technical success was 100%. The subclavian artery was occluded/covered in 14 (21%) cases. Average length of total aortic coverage was 20 cm. 30-day mortality for elective and nonelective cases were 0% and 22%, respectively (overall 12%). Re-intervention rate was 9%. Endoleaks were seen in 8 cases of which 3 needed re-intervention. Devices used were Medtronic (27, 40%) Cook (33, 50%) and Gore 7 (10%). 1-year and 5-year follow-up was available for 33 (49%) and 17 (25%) patients, respectively.

Conclusion: Our experience and outcomes in a diverse patient population, including emergency and elective cases across various aortic pathologies, confirm that TEVAR is a safe and effective minimally invasive procedure with low re-intervention rates. The review highlights the importance of meticulous patient selection, procedural techniques, and the need for extended follow-up to assess the durability and effectiveness of TEVAR interventions. A few representative cases could be included for discussion.

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Artikel online veröffentlicht:
02. April 2024