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Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement
Published on: December 11, 2017
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Outcomes after endovascular reintervention for aortic interventions
Amit S Kainth1, Tej A Sura2, Michael S Williams1
1Division of Vascular and Endovascular Surgery, Department of Surgery, Saint Louis University, St Louis, Mo.
Journal of Vascular Surgery
|September 30, 2021
Summary
Endovascular reintervention after aortic procedures, particularly open abdominal aortic procedures (OAP), is linked to increased mortality compared to primary endovascular abdominal aortic aneurysm repair (EVAR). Reinterventions following OAP show higher mortality rates than those after prior EVAR.
Area of Science:
- Vascular Surgery
- Endovascular Interventions
- Aortic Aneurysm Repair
Background:
- Endovascular reinterventions are common following prior open or endovascular aortic repair.
- The Global Registry for Endovascular Aortic Treatment (GREAT) database provides data for comparative outcome analysis.
Purpose of the Study:
- To compare outcomes of endovascular reinterventions after open abdominal aortic procedures (OAP) versus previous endovascular abdominal aortic aneurysm repair (EVAR).
- To compare reintervention outcomes with primary EVAR.
Main Methods:
- Analysis of the GREAT database including 3974 EVAR patients.
- Grouping patients based on prior OAP or EVAR for reintervention analysis.
- Cox proportional analysis to identify mortality predictors.
Main Results:
- Reintervention after OAP showed higher 2-year all-cause mortality (32.7%) than after EVAR (17.7%).
- Reintervention cohort was older and had higher rates of aortic branch procedures.
- Both all-cause and aorta-related mortality were higher in the reintervention group versus primary EVAR.
Conclusions:
- Endovascular reintervention for aortic pathology is associated with increased mortality compared to primary EVAR.
- Reinterventions following OAP carry higher mortality risks than those after prior EVAR.
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