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Thoracic endovascular aortic repair – a Brazilian experience in 255 patients over a period of 112 months

^a UNIOESTE – Parana's West State University, Cascavel, Brazil
^b FAMERP – São Jose do Rio Preto Medical School, São José do Rio Preto, Brazil
^c UFRGS – Rio Grande do Sul Federal University, Porto Alegre, Brazil
^d IDAC – Institute of Aortic Diseases of Cascavel, Cascavel, Brazil
^e CRIVA – Hospital of Portuguese Beneficence, São José do Rio Preto, Brazil

*Corresponding author. Rua Terra Roxa, 1425, Cascasvel, PR, 85816-360, Brazil. Tel.: +55-45-91077197; fax: +55-45-32279260.

E-mail address: ruimsalmeida{at}iccop.com.br (R.M.S. Almeida).

The aim of this study is to analyze the immediate and late evolution for death and reintervention in a thoracic endovascular aortic repair (TEVAR) group, over a follow-up period of 112 months. Retrospective data of 255 patients, from 1998 to 2007, were obtained. The most prevalent diseases were thoracic aortic aneurysms (89), thoracic and abdominal aneurysms (85) and thoracic aortic dissections (61). The mean age was 63.2 years and 67.1% were male. Three hundred and three endoprostheses were used. Causes of morbidity, in the immediate postoperative period, were hyperthermia (45.9%), endoleaks (9.8% – being 7.1% type I), vascular complications (5.2%), renal insufficiency (3.1%) and neurological complications (3.1%). There were two (0.8%) hospital deaths and 17 (6.7%) late deaths. Time of follow-up was up to 112 months (mean of 60 months). The Kaplan–Meier curve analysis showed an increase of reintervention, compared with death, after a follow-up period of 42 months. Freedom from death at 36, 60 and 112 months was 96%, 89.1%, 85.1% and for reintervention, for the same periods was 93.6%, 82.7%, 57.2%, respectively. This study showed low incidence of prostheses related morbidity and immediate mortality. After a period of 42 months there was an increase on the percentual tax of reintervention.

Key Words: Thoracic aorta; Aortic aneurysms; Endoprosthesis; Endovascular treatment