A Single-Center Experience with Paravisceral Transaortic Endarterectomy: Establishing Evidence for Efficacy and...

The outcomes of paravisceral transaortic endarterectomy (TAE) performed at our tertiary care center were reviewed.

A retrospective analysis was performed of patients with paravisceral atherosclerotic occlusive disease who underwent TAE between January 2006 and April 2026. Patient demographics, operative details, and postoperative outcomes were assessed.

Nineteen paravisceral TAE patients were majority White (80%) and female (68%) with mean age of 66 years. Major risk factors included active tobacco use (42%), hypertension (79%), and hyperlipidemia (79%). Supraceliac clamping was performed in 18 (95%) with mean clamp time of 33 minutes. Mean operating room time was 490 minutes (±116 minutes) and estimated blood loss was 1,167 mL (±934 mL). Intraoperative duplex was performed in 10 patients with reintervention in 3 patients for retained distal plaque and 1 patient for dissection. Postoperative complications included pneumonia (21%), acute kidney injury (25%), and gastrointestinal bleeding (5%). Median hospital length of stay was 15 days. There were no 30-day mortalities. Two patients required readmission within 30 days: for disposition planning and chest wall hematoma. Two patients required 1-year reinterventions for superior mesenteric artery stenosis, superior mesenteric artery thrombosis. Mean follow-up was 30 months with 17 of 19 (89%) alive without recurrent symptoms.

Paravisceral TAE is feasible and effective for complex paravisceral aortic occlusive disease, when unsuitable for endovascular methods. TAE demonstrated favorable outcomes, with no 30-day mortality, low reintervention rates, and durable symptom relief in most patients. These findings support the continued role of TAE in appropriately selected patients at specialized centers.