Five-Year Survival and Complications of Thoracic Endovascular Aortic Repair (TEVAR): A Single Tertiary Center Registry for All-Comers Patients

Haji-Zeinali, Ali Mohammad; Mansouri, Pejman; Hoseini, Neda Raiss; Abbasi, Kiomars; Shirzad, Mahamoud; Jameie, Mana; Hajizeinali, Mohammad Mohsen

doi:10.1016/j.carrev.2023.01.020

Cited by 4 publications

(1 citation statement)

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“…Even for short-term mortality, the outcome most commonly reported, only three studies provided separate data for both elective and urgent aortic pathologies [5,9,11]. Death rates were lower after elective procedures, an observation generally supported by the existing literature [39][40][41][42][43]. Thus, in studies consisting of elderly populations, more detailed reporting of distinct post-TEVAR outcomes for the most common aortic presentations and for elective and emergency procedures is recommended.…”

Section: Discussionmentioning

confidence: 91%

Comparative Analysis of Morbidity and Mortality Outcomes in Elderly and Nonelderly Patients Undergoing Elective TEVAR: A Systematic Review and Meta-Analysis

Frisiras,

Giannas,

Bobotis

et al. 2023

JCM

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Objective: Due to an ever-increasing ageing population and limited available data around the use of thoracic endovascular aortic repair (TEVAR) in elderly patients, investigating its efficacy and safety in this age cohort is of vital importance. We thus reviewed the existing literature on this topic to assess the feasibility of TEVAR in elderly patients with severe thoracic aortic pathologies. Methods: We identified all original research studies that assessed TEVAR in elderly patients published up to 2023. Morbidity, as assessed by neurological and respiratory complications, endoleaks, and length of stay, was the primary endpoint. Short-term mortality and long-term survival were the secondary endpoints. The Mantel–Haenszel random and fixed effects methods were used to calculate the odds ratios for each outcome. Further sensitivity and subgroup analyses were performed to validate the outcomes. Results: Twelve original studies that evaluated elective TEVAR outcomes in elderly patients were identified. Seven studies directly compared the use of TEVAR between an older and a younger patient group. Apart from a shorter hospital stay in older patients, no statistically significant difference between the morbidity outcomes of the two different cohorts was found. Short-term mortality and long-term survival results favoured the younger population. Conclusions: The present meta-analysis indicates that, due to a safe perioperative morbidity profile, TEVAR should not be contraindicated in patients based purely on old age. Further research using large patient registries to validate our findings in elderly patients with specific aortic pathologies and both elective and emergency procedures is necessary.

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