1. Sex Comparative Analysis of Branched and Fenestrated Endovascular Aortic Arch Repair Outcomes.
- Author
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Nana, Petroula, Panuccio, Giuseppe, Torrealba, José I., Rohlffs, Fiona, Spanos, Konstantinos, and Kölbel, Tilo
- Abstract
Female sex is a risk factor for adverse events after endovascular aortic repair. Sex comparative early and midterm outcomes of fenestrated and branched endovascular aortic arch repair (F/B-Arch) are presented. A single centre retrospective sex comparative analysis of consecutive patients managed with F/B-Arch was conducted according to STROBE. Primary outcomes were sex comparative technical success, death, and cerebrovascular morbidity at 30 days. Kaplan–Meier estimates were used for follow up outcomes. Among 209 patients, 38.3% were women. Coronary artery disease (p <.001) and previous myocardial infarction (p =.01) were more common in women. Non-native proximal aortic landing was higher in women (women: 51.3%; men: 31.8%, p =.005) and the aortic dissection rate was lower (28.8% vs. 48.1%, p =.005). Proximal landing to Ishimaru zones showed no difference (zone 0: p =.18; zone 1: p =.47; zone 2: p =.39). Graft configurations were equally distributed. In total, 416 supra-aortic trunks were bridged. The median number of revascularisations per patient was two (interquartile range 1, 3), with no difference between sexes (p =.54). Technical success (women: 97.5%; men: 96.9%, p =.80), 30 day mortality rate (women: 10%; men: 9.3%, p =.86), and cerebrovascular morbidity (women: 11.3%; men: 17.1%, p =.25) were similar. Women presented more access related complications (women: 32.5%; men: 16.3%, p =.006), without affecting access related re-interventions (p =.55). Survival (women: 81.1%, 95% confidence interval [CI] 76.3 – 85.9%; men: 79.8%, 95% CI 76.0 – 83.6%) and freedom from re-intervention (women: 56.6%, 95% CI 50.4 – 62.8%; men: 55.3%, 95% CI 50.1 – 60.5%) at 12 months were similar (log rank, p =.40 and p =.41, respectively). Both sexes presented similar outcomes after F/B-Arch. Appropriate patient selection may decrease the effect of sex in F/B-Arch outcomes. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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