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Outcomes of elective and non-elective fenestrated-branched endovascular aortic repair for treatment of thoracoabdominal aortic aneurysms

2023Journal article Restricted access
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dc.contributor.authorDias-Neto, Marina
dc.contributor.authorVacirca, Andrea
dc.contributor.authorHuang, Ying
dc.contributor.authorBaghbani-Oskouei, Aidin
dc.contributor.authorJakimowicz, Tomasz
dc.contributor.authorMendes, Bernardo C.
dc.contributor.authorKolbel, Tilo
dc.contributor.authorSobocinski, Jonathan
dc.contributor.authorBertoglio, Luca
dc.contributor.authorMees, Barend
dc.contributor.authorGargiulo, Mauro
dc.contributor.authorDias, Nuno
dc.contributor.authorSchanzer, Andres
dc.contributor.authorGasper, Warren
dc.contributor.authorBeck, Adam W.
dc.contributor.authorFarber, Mark A.
dc.contributor.authorMani, Kevin
dc.contributor.authorTimaran, Carlos
dc.contributor.authorSchneider, Darren B.
dc.contributor.authorPedro, Luís M
dc.contributor.authorTsilimparis, Nikolaos
dc.contributor.authorHaulon, Stéphan
dc.contributor.authorSweet, Matthew P.
dc.contributor.authorFerreira, Emília
dc.contributor.authorEagleton, Matthew
dc.contributor.authorYeung, Kak Khee
dc.contributor.authorKhashram, Manar
dc.contributor.authorJama, Katarzyna
dc.contributor.authorPanuccio, Giuseppe
dc.contributor.authorRohlffs, Fiona
dc.contributor.authorMesnard, Thomas
dc.contributor.authorChiesa, Roberto
dc.contributor.authorKahlberg, Andrea
dc.contributor.authorSchurink, Geert Willem
dc.contributor.authorLemmens, Charlotte
dc.contributor.authorGallitto, Enrico
dc.contributor.authorFaggioli, Gianluca
dc.contributor.authorKarelis, Angelos
dc.contributor.authorParodi, Ezequiel
dc.contributor.authorGomes, Vivian
dc.contributor.authorWanhainen, Anders
dc.contributor.authorHabib, Mohammed
dc.contributor.authorColon, Jesus Porras
dc.contributor.authorPavarino, Felipe
dc.contributor.authorBaig, Mirza S.
dc.contributor.authorGouveia e Melo, Ryan Eduardo Costeloe De
dc.contributor.authorCrawford, Sean
dc.contributor.authorZettervall, Sara L.
dc.contributor.authorGarcia, Rita
dc.contributor.authorRibeiro, Tiago
dc.contributor.authorAlves, Gonçalo
dc.contributor.authorGonçalves, Frederico Bastos
dc.contributor.authorKappe, Kaj Olav
dc.contributor.authorMariko van Knippenberg, Samira Elize
dc.contributor.authorTran, Bich Lan
dc.contributor.authorGormley, Sinead
dc.contributor.authorOderich, Gustavo S.
dc.date.accessioned2023-09-15T10:57:16Z
dc.date.available2023-09-15T10:57:16Z
dc.date.issued2023
dc.descriptionCopyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.pt_PT
dc.descriptionThis work was presented at the 143rd Annual Meeting of the American Surgical Association, Toronto, Ontario, Canada, April 20-22, 2023.pt_PT
dc.description.abstractObjective: To describe outcomes after elective and non-elective fenestrated-branched endovascular aortic repair (FB-EVAR) for thoracoabdominal aortic aneurysms (TAAAs). Background: FB-EVAR has been increasingly utilized to treat TAAAs; however, outcomes after non-elective versus elective repair are not well described. Methods: Clinical data of consecutive patients undergoing FB-EVAR for TAAAs at 24 centers (2006-2021) were reviewed. Endpoints including early mortality and major adverse events (MAEs), all-cause mortality, and aortic-related mortality (ARM), were analyzed and compared in patients who had non-elective versus elective repair. Results: A total of 2603 patients (69% males; mean age 72±10 year old) underwent FB-EVAR for TAAAs. Elective repair was performed in 2187 patients (84%) and non-elective repair in 416 patients [16%; 268 (64%) symptomatic, 148 (36%) ruptured]. Non-elective FB-EVAR was associated with higher early mortality (17% vs 5%, P <0.001) and rates of MAEs (34% vs 20%, P <0.001). Median follow-up was 15 months (interquartile range, 7-37 months). Survival and cumulative incidence of ARM at 3 years were both lower for non-elective versus elective patients (50±4% vs 70±1% and 21±3% vs 7±1%, P <0.001). On multivariable analysis, non-elective repair was associated with increased risk of all-cause mortality (hazard ratio, 1.92; 95% CI] 1.50-2.44; P <0.001) and ARM (hazard ratio, 2.43; 95% CI, 1.63-3.62; P <0.001). Conclusions: Non-elective FB-EVAR of symptomatic or ruptured TAAAs is feasible, but carries higher incidence of early MAEs and increased all-cause mortality and ARM than elective repair. Long-term follow-up is warranted to justify the treatment.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationAnn Surg. 2023 Oct 1;278(4):568-577pt_PT
dc.identifier.doi10.1097/SLA.0000000000005986pt_PT
dc.identifier.eissn1528-1140
dc.identifier.issn0003-4932
dc.identifier.urihttp://hdl.handle.net/10451/59326
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherLWW Journalspt_PT
dc.relation.publisherversionhttps://journals.lww.com/annalsofsurgery/pages/default.aspxpt_PT
dc.subjectFenestrated-branched endovascular aortic repairpt_PT
dc.subjectThoracoabdominal aortic aneurysmpt_PT
dc.subjectNon-elective repairpt_PT
dc.subjectElective repairpt_PT
dc.titleOutcomes of elective and non-elective fenestrated-branched endovascular aortic repair for treatment of thoracoabdominal aortic aneurysmspt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage577pt_PT
oaire.citation.issue4pt_PT
oaire.citation.startPage568pt_PT
oaire.citation.titleAnnals of Surgerypt_PT
oaire.citation.volume278pt_PT
person.familyNamePedro
person.givenNameLuís
person.identifier.ciencia-id0B14-1812-24DC
person.identifier.orcid0000-0003-4310-9324
person.identifier.scopus-author-id7004454630
rcaap.rightsrestrictedAccesspt_PT
rcaap.typearticlept_PT
relation.isAuthorOfPublicationff4d548a-318e-4368-b735-e8b82e060dd3
relation.isAuthorOfPublication.latestForDiscoveryff4d548a-318e-4368-b735-e8b82e060dd3

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