Clinical predictors of mortality and endoleak following EVAR and TEVAR
Can Baba Arin1,2, Ishak Ahmed Abdi2, Mesut Karataş2
1Department of Cardiology, Health Science University, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Centre, İstanbul, Turkey.
Objective:
To evaluate clinical outcomes and identify predictors of mortality and endoleak after endovascular aneurysm repair (EVAR) and thoracic endovascular aortic repair (TEVAR) procedures.
Methods:
A retrospective cohort study of 164 EVAR and TEVAR patients (January 2000-December 2022) was conducted. Data on demographics, comorbidities, aneurysm size, and clinical outcomes were extracted. Statistical analysis included Pearson's chi-square test, Student's t-test, Mann-Whitney U test, and multivariate logistic regression. Model performance was assessed by receiver operating characteristic and Hosmer-Lemeshow tests.
Results:
Overall mortality was 7%, and endoleak incidence was 20.75%. Diabetes mellitus was an independent predictor of mortality [adjusted odds ratio (AOR) = 3.93; 95% CI: 1.51-10.24, P = 0.005], and aneurysm size (>7 cm) independently predicted endoleaks (AOR = 3.21; 95% CI: 1.28-8.06, P = 0.013). Physician specialty and procedure type did not significantly predict outcomes. Model discrimination (area under the curve = 0.96) and calibration (Hosmer-Lemeshow P = 0.400) were strong.
Conclusion:
Diabetes mellitus and aneurysm size (>7 cm) significantly influence clinical outcomes following EVAR and TEVAR, guiding risk stratification and patient management.
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