scholarly journals A Single Center Study on the Risks of Peri-Intervention Stroke in Thoracic Endovascular Aortic Repair (TEVAR) and Endovascular Abdominal Aortic Repair (EVAR)

2022 ◽  
Vol 9 (1) ◽  
pp. 10
Author(s):  
Jirayoot Chusooth ◽  
Chanon Kongkamol ◽  
Ruedeekorn Suwannanon ◽  
Dhanakom Premprabha ◽  
Voravit Chittithavorn ◽  
...  
Keyword(s):  
Multivariable Analysis ◽  
Case Control ◽  
Thoracic Endovascular Aortic Repair ◽  
Endovascular Aortic Repair ◽  
Univariable Analysis ◽  
Post Intervention ◽  
Aortic Repair ◽  
Abdominal Aortic ◽  
Single Center Study ◽  
Endovascular Abdominal Aortic Repair

(1) Background: The risk factors of peri-intervention stroke (PIS) in thoracic endovascular aortic repair (TEVAR) and endovascular abdominal aortic repair (EVAR) are different. This study aimed to compare the risks of PIS in both interventions. (2) Methods: Patients who had suffered a PIS related to TEVAR or EVAR from January 2008 to June 2015 in Songklanagarind Hospital were selected as the cases, while patients who had not suffered PIS were randomly selected to create a 1:4 case: control ratio for analysis. The associations between the factors from pre- to post-intervention and PISs in TEVAR or EVAR cases were analyzed by univariable analysis (p < 0.1). The independent risks of PIS were identified by multivariable analysis and presented in odds ratios (p < 0.05). (3) Results: A total of 17 (2.2%) out of 777 patients who had undergone TEVAR or EVAR experienced PIS, of which 9/518 (1.7%) and 8/259 (3.1%) cases were in TEVAR and EVAR groups, respectively. PIS developed within the first 24 h in nine (52.9%) cases. Large vessel ischemic stroke or watershed infarctions were the most common etiologies of PIS. The independent risks of PIS were the volume of intra-intervention blood loss (1.99 (1.88–21.12), p < 0.001) in the TEVAR-related PIS, and intervention time (2.16 (1.95–2.37), p = 0.010) and post-intervention hyperglycemia (18.60 (1.60–216.06), p = 0.001) in the EVAR-related PIS. There were no differences in the rate of PIS among the operators, intervention techniques, and status of the interventions performed. (4) Conclusion: The risks of PIS in TEVAR or EVAR in our center were different and possibly independent of the operator expertise and intervention techniques.

Retroperitoneal Versus Direct Femoral Artery Approach for Thoracic Endovascular Aortic Repair Access: A Case–Control Study

2011 ◽  
Vol 25 (3) ◽  
pp. 340-344 ◽  
Author(s):  
Vahid Etezadi ◽  
Barry T. Katzen ◽  
James F. Benenati ◽  
Sara Alehashemi ◽  
Athanassios I. Tsoukas ◽  
...  
Keyword(s):  
Femoral Artery ◽  
Case Control Study ◽  
Case Control ◽  
Thoracic Endovascular Aortic Repair ◽  
Endovascular Aortic Repair ◽  
Aortic Repair ◽  
Control Study

Increased ischemic complications in fenestrated and branched endovascular abdominal aortic repair compared with standard endovascular aortic repair

2020 ◽  
Vol 72 (1) ◽  
pp. 36-43 ◽  
Author(s):  
Gregory G. Westin ◽  
Caron B. Rockman ◽  
Mikel Sadek ◽  
Bhama Ramkhelawon ◽  
Matthew R. Cambria ◽  
...  
Keyword(s):  
Endovascular Aortic Repair ◽  
Aortic Repair ◽  
Abdominal Aortic ◽  
Ischemic Complications ◽  
Endovascular Abdominal Aortic Repair

Predictors of 30-day readmission and resource utilization after thoracic endovascular aortic repair

2020 ◽  
Vol 58 (3) ◽  
pp. 574-582
Author(s):  
Amit Iyengar ◽  
Nicholas J Goel ◽  
John J Kelly ◽  
Jason Han ◽  
Chase R Brown ◽  
...  
Keyword(s):  
Multivariable Analysis ◽  
Hospital Costs ◽  
Vascular Diseases ◽  
Thoracic Endovascular Aortic Repair ◽  
Endovascular Aortic Repair ◽  
Hospital Length Of Stay ◽  
Aortic Diseases ◽  
Abdominal Aneurysm ◽  
Average Hospital ◽  
Aortic Repair

Abstract OBJECTIVES The introduction and expansion of thoracic endovascular aortic repair (TEVAR) have revolutionized the treatment of a variety of thoracic aortic diseases. We sought to evaluate the incidence, causes, predictors and costs associated with 30-day readmission after TEVAR in a nationally representative cohort. METHODS Adult patients undergoing isolated TEVAR were identified in the National Readmissions Database from 2010 to 2014. Hospital costs were estimated by converting individual hospital charge data adjusted to 2014 consumer price indices. Multivariable logistic regression was utilized to determine hospital- and patient-level factors associated with readmissions. RESULTS A total of 24 983 TEVARs were noted during the study period; the average age of the patients was 65 ± 16 years; 40% were women. The most common indication was an intact thoracic aneurysm (43.5%), followed by aortic dissection (30.5%). The average cost of the index admission was $63 644 ± $52 312; the average hospital stay was 11 ± 14 days; the index mortality rate was 6.7%. Readmissions within 30 days occurred in 17.4% of patients. Indications for readmission were varied; the most common aetiologies were cardiac (17.8%), infectious (16.0%) and pulmonary (12.1%). On multivariable analysis, the strongest predictor of readmission was the diagnosis, with a ruptured thoraco-abdominal aneurysm having the highest readmission burden (adjusted odds ratio 2.23, 1.17–4.24; P = 0.015). Notably, hospital volume did not predict index hospital length of stay, costs or 30-day readmissions (all P &gt; 0.10). CONCLUSIONS Annual TEVAR volume was not associated with any of the outcomes assessed. Rather, indication for TEVAR was the strongest predictor for many outcomes. As TEVAR becomes increasingly utilized, a focus on cardiac and vascular diseases may reduce readmissions and improve quality of care.

scholarly journals Abdominal Aortic Remodeling After Thoracic Endovascular Aortic Repair for Type B (DeBakey IIIb) Aortic Dissection

2020 ◽  
Vol 71 (1) ◽  
pp. e22
Author(s):  
Hunter M. Ray ◽  
Daniel Ocazionez ◽  
Charles C. Miller ◽  
Harleen K. Sandhu ◽  
Naveed U. Saqib ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Thoracic Endovascular Aortic Repair ◽  
Endovascular Aortic Repair ◽  
Type B ◽  
Aortic Repair ◽  
Abdominal Aortic ◽  
Aortic Remodeling

Association of left subclavian artery coverage without revascularization and spinal cord ischemia in patients undergoing thoracic endovascular aortic repair: A Vascular Quality Initiative® analysis

Vascular ◽  
2017 ◽  
Vol 25 (6) ◽  
pp. 587-597 ◽  
Author(s):  
Pedro GR Teixeira ◽  
Karen Woo ◽  
Adam W Beck ◽  
Salvatore T Scali ◽  
Fred A Weaver ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Subclavian Artery ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Left Subclavian Artery ◽  
Spinal Cord Ischemia ◽  
Multivariable Analysis ◽  
Thoracic Endovascular Aortic Repair ◽  
Endovascular Aortic Repair ◽  
Aortic Repair

Objectives Investigate the impact of left subclavian artery coverage without revascularization on spinal cord ischemia development in patients undergoing thoracic endovascular aortic repair. Methods The Vascular Quality Initiative thoracic endovascular aortic repair module (April 2011–July 2014) was analyzed. Patients undergoing left subclavian artery coverage were divided into two groups according to revascularization status. The association between left subclavian artery revascularization with the primary outcome of spinal cord ischemia and the secondary outcome of stroke was assessed with multivariable analysis adjusting for between-group baseline differences. Results The left subclavian artery was covered in 508 (24.6%) of the 2063 thoracic endovascular aortic repairs performed. Among patients with left subclavian artery coverage, 58.9% underwent revascularization. Spinal cord ischemia incidence was 12.1% in the group without revascularization compared to 8.5% in the group undergoing left subclavian artery revascularization (odds ratio (95%CI): 1.48(0.82–2.68), P = 0.189). Multivariable analysis adjustment identified an independent association between left subclavian artery coverage without revascularization and the incidence of spinal cord ischemia (adjusted odds ratio (95%CI): 2.29(1.03–5.14), P = 0.043). Although the incidence of stroke was also higher for the group with a covered and nonrevascularized left subclavian artery (12.1% versus 8.5%), this difference was not statistically significant after multivariable analysis (adjusted odds ratio (95%CI): 1.55(0.74–3.26), P = 0.244). Conclusion For patients undergoing left subclavian artery coverage during thoracic endovascular aortic repair, the addition of a revascularization procedure was associated with a significantly lower incidence of spinal cord ischemia.

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