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Objective: The aim of this study was to evaluate the association between sex and outcomes following thoracic endovascular aortic repair (TEVAR) for intact isolated descending thoracic aortic aneurysms (iiDTAA)., Background: Data regarding sex-related long-term outcomes after TEVAR for iiDTAA are limited and conflicting results regarding perioperative outcomes have been reported., Methods: We included all TEVAR for iiDTAA between 2014 and 2019 in the Vascular Quality Initiative linked to Medicare claims, allowing reliable assessment of long-term outcome data. Primary outcomes included 5-year mortality, reinterventions, and ruptures of the thoracic aorta. Secondarily, we assessed perioperative outcomes., Results: We identified 685 patients, of which 54% were females. Females had higher aortic size index {females vs males: 3.31 [interquartile range (IQR), 2.81-3.85] cm/m 2 vs 2.93 (IQR, 2.42-3.36) cm/m 2 ; P <0.001}, were more frequently symptomatic (31% vs 20%; P =0.001), had longer procedure time [111 (IQR, 72-165) minutes vs 97 (IQR, 70-146) minutes] and more iliac procedures (16% vs 7.6%; P =0.001). Compared with males, females had similar rates of 5-year mortality [58% vs 53%; hazard ratio (HR), 0.93; 95% CI: 0.71-1.22; P =0.61), reinterventions (39% vs 30%; HR, 1.12; 95% CI: 0.73-1.73; P =0.60), and late ruptures (0.6% vs 1.2%; HR, 0.87; 95% CI: 0.12-6.18; P =0.89). After adjustment, these outcomes remained similar through 5 years. Furthermore, perioperative mortality was not significantly different between sexes (4.1% vs 2.2%; P =0.25), as were rates of any complication as a composite outcome (16% vs 21%; P =0.16), as well as of individual complications (all P >0.05)., Conclusion: Our findings suggest that females who undergo TEVAR for iiDTAA have similar 5-year and perioperative outcomes as compared with males., Competing Interests: H.J.M.V. is a consultant of Medtronic, WL Gore, Terumo, Atrivion, Endologix, Philips. S.T. is a consultant for Terumo, Medtronic, and WL Gore. The remaining authors report no conflicts of interest., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

Background: The Gore conformable TAG thoracic endoprosthesis (CTAG) was engineered to enhance conformability in the thoracic aorta and has demonstrated greater deployment accuracy and wall apposition than the original TAG device. The Food and Drug Administration approved the CTAG in 2011 based on the 1-year results of the pivotal trial for the CTAG device. In the present report, we have documented the outcomes for those patients through 5 years., Methods: The CTAG aneurysm study was a prospective, multicenter trial that assessed the safety and effectiveness of the CTAG device as treatment of descending thoracic aortic aneurysms. Follow-up imaging assessments consisted of radiographs and computed tomography at annual intervals through 5 years. A core imaging laboratory was used to assess the aneurysm size, device integrity, and endoleaks., Results: A total of 66 patients were enrolled (51 pivotal arm patients and 15 continued access patients) from October 2009 through September 2011. The baseline characteristics, procedural characteristics, and outcomes through 2 years were reported previously. Through 5 years, five patients (7.6%) had required device-related reintervention (one type Ia endoleak or contained rupture of the descending thoracic aorta, one type Ib endoleak, two indeterminate endoleaks, and one thoracic aortic pseudoaneurysm). Four patients (6.1%) had died of aneurysm-related causes, with one death occurring within 30 days of the index procedure. A total of 24 patients (36.3%) had died during the 5-year study period. Seven patients (10.6%) had experienced stroke or transient ischemic attack through 5 years, with one early stroke (postoperative day 28). Prosthesis or intercomponent migration was observed in six patients (9.1%) through 5 years; however, no patient had developed a type III junctional endoleak. No stent-graft fracture or compression was observed through 5 years. At 5 years, 14 patients (50.0%) showed sac regression, 5 (17.9%) showed sac expansion, and 9 (32.1%) showed sac stability using on a 5-mm threshold for change., Conclusions: Thoracic endovascular aortic repair with the CTAG device was associated with low rates of aneurysm-related mortality and reintervention through 5 years. Proximal endoleak was rare, and most patients showed sac regression or stability at 5 years after the initial thoracic endovascular aortic repair., (Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.)