A review of follow-up outcomes after elective endovascular repair of degenerative thoracic aortic aneurysms

Abstract

Long-term outcomes of elective thoracic endovascular aortic repair (TEVAR) for degenerative thoracic aortic aneurysms (TAA) are not well defined. A review of the literature on the follow-up outcomes of elective TEVAR for degenerative TAA resulted in 22 relevant articles. Two- and five-year freedom from aneurysm-related death varied between 93.0% and 100.0%, and 82.4% to 92.7%, respectively. Two-year and five-year all-cause survival ranged between 68.0% and 97.2% and 47.0% to 78.0%, respectively. Follow-up ranged between 17.3 and 66.0 months. Most common endograft-related complication was endoleak, with reported rate between 1.4% and 14.8% during six months up to five years of follow-up. Endovascular reinterventions were reported in 0.0-32.3%, secondary open surgery was needed in 0.0% to 4.7% during follow-up. Aneurysm-related survival rates after elective TEVAR for degenerative TAA are acceptable. However, reported incidences of endograft-related complications vary considerably in the literature, but the majority can be managed with conservative treatment or additional endovascular procedures.

Outcome of thoracic endovascular aortic repair in patients with thoracic and thoracoabdominal aortic aneurysms

“…4 All-cause survival rates at 5 years are 47% to 78%, and RIs are reported in up to 32% of patients after TEVAR for TAA. 5 The most valid long-term data are derived from registry studies; however, these numbers may not represent real-world outcomes because high-risk patients are often excluded. 6,7 More outcome data are needed to improve clinical decision making and FU regimens after TEVAR.…”

Valiant NAVION stent graft system application: First Asian case‐series analysis

“…The complexity and variability in landing zones affect deployment accuracy and success, and incomplete exclusion of diseased segments of the aorta can result in endoleaks. The rate of endoleaks from TEVAR range from 3.4% to 42.2% with Type I endoleak being the commonest at 41.4% followed by Type II and III endoleaks 14 . The Valiant TM Navion stent‐graft comes with two proximal stent‐graft configurations, the FreeFlo, and the CoveredSeal device.…”

Thoracic Endovascular Aortic Repair for Pseudoaneurysm after Interrupted Aortic Arch Repair

“…Another problem is that the long-term performance and durability of the stent graft remain unclear. On the other hand, no difference in the mid-term outcomes between TEVAR and open surgery has been reported for an atherosclerotic descending aortic aneurysm, 5) and continuous careful follow-up is important. If we can confirm that the long-term outcomes of TEVAR are comparable with those of open surgery in the future, stent graft therapy may become the first choice of treatment for young patients who are at a high risk of re-open surgery.…”