Outcomes of Staged Completion Extent II Thoracoabdominal Aortic Aneurysm Repair

Area of Science:

• Vascular Surgery
• Aortic Aneurysm Repair
• Neurosurgery

Background:

• Thoracoabdominal aortic aneurysms (TAAA) present significant risks, particularly extent II TAAA, with high rates of spinal cord injury (SCI).
• Evaluating surgical repair strategies for extent II TAAA is crucial for improving patient outcomes and minimizing complications.

Purpose of the Study:

• To compare the outcomes of primary versus staged-completion repair for extent II thoracoabdominal aortic aneurysms (TAAA).
• To assess the impact of different repair strategies on operative mortality, early and delayed spinal cord injury (SCI), and other major complications.

Main Methods:

• A retrospective review of 290 patients undergoing extent II TAAA repair between January 1999 and September 2024 was conducted.
• Patients were categorized into primary (single-stage) and staged-completion (multi-stage) repair groups.
• Outcomes including operative mortality, early and delayed SCI, respiratory failure, dialysis, and stroke were analyzed.

Main Results:

• Operative mortality and early SCI rates were comparable between primary (14.4%, 5.0%) and staged-completion (16.5%, 4.6%) repair groups.
• Delayed SCI occurred significantly less frequently in the staged-completion group (7.3%) compared to the primary repair group (14.9%).
• Rates of respiratory failure, dialysis requirement, and stroke did not differ significantly between the two repair strategies.

Conclusions:

• Staged-completion repair for extent II TAAA yields comparable overall outcomes to primary repair.
• Staged-completion repair significantly reduces the incidence of delayed spinal cord injury (SCI) after extent II TAAA repair.