Thoracic Aortic Aneurysm Sac Remodeling After Thoracic Endovascular Aortic Repair Affects Late Outcomes After Repair

Prior studies have demonstrated failure of sac regression after endovascular aortic repair (EVAR) is associated with higher rates late mortality and reinterventions. However, the effect aneurysm remodeling on outcomes thoracic EVAR (TEVAR) has not been studied. All patients who underwent TEVAR for degenerative in Vascular Quality Initiative from 2011 to 2021 1 -year follow-up imaging (±6 months) were identified. Sac was defined as expansion (≥5 mm increase), stable (<5 change), or decrease). Logistic used examine factors independently expansion. A subgroup analysis 4-year survival, rupture, reintervention assessed using Kaplan-Meier estimates Cox 2018 linkage Medicare claims data. We identified 2247 1-year aneurysm. Among these patients, 21% expansion, 38% sac, 42% regression. Aortic diameter smallest (expansion 48 vs 51 59 mm; P < .001). had highest rate any completion endoleak (12% 7.0% 6.1%; = .015) type II (5.4% 2.2% 2.0%; .025). Factors included 5.5 cm less (odds ratio [OR], 1.7; 95% confidence interval [CI], 1.2-2.3), increasing age (by decade, OR, 1.2; CI, 1.1-1.4), (OR, 3.5; 1.2-3.4). 976 data, 19% 36% 45% No difference observed survival (87% 92% 90%; log-rank .550). Late rupture (15% 8.5% 5.2%; .013) (Fig 1). Furthermore, when compared regression, risk (hazard [HR], 3.4; 1.4-8.5). Four-year (54% 37% 30%; .001) 2). When (HR, 2.3; 1.5-3.4). increased reintervention. odds during follow-up. Further study warranted determine if shorter at can improve patients.Fig 2Kaplan-Meier stratified by (TEVAR).View Large Image Figure ViewerDownload Hi-res image Download (PPT)