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Observational Study
. 2024 Oct 1;66(4):ezae343.
doi: 10.1093/ejcts/ezae343.

An analysis of early and long-term gender-related outcomes after thoracic endovascular aortic repair

Gabriele Piffaretti  1 , Francesca Mauri  1 , Gaddiel Mozzetta  2 , Sergio Zacà  3 , Raffaele Pulli  4 , Giovanni Pratesi  2 , Aaron Thomas Fargion  4 , Domenico Angiletta  3 ; I.C.E., Italian Collaborators for Thoracic Evar Registry
Collaborators, Affiliations
Observational Study

An analysis of early and long-term gender-related outcomes after thoracic endovascular aortic repair

Gabriele Piffaretti et al. Eur J Cardiothorac Surg. .

Abstract

Objectives: To evaluate gender-related outcomes during endovascular treatment of thoracic and thoraco-abdominal aortic diseases (TEVAR).

Methods: Multicentre, retrospective, observational cohort study. All TEVARs between January 2005 and April 2023 were identified. Primary outcomes were 30-day mortality and cumulative survival. Secondary outcomes were vascular access complications, and freedom from TEVAR-related reintervention. Interventions performed in male patients were matched to females on the basis of a one-to-one coarsened exact matching.

Results: We identified 151 males who were matched with 151 females. Mortality at 30 days was not statistically different between females and males (11.2% vs 11.2%; P = 1.0). At binary logistic regression analysis, duration of intervention (P = 0.001) and emergency TEVAR (P = 0.001) were associated with mortality at 30 days. Gender did not impact the access vessel complication rate [n = 6 (4.0%) vs n = 5 (3.3%); P = 1.0]. The median follow-up was 46 (interquartile range, 7-84) months with no difference between males and females [median 50 (11-95) vs 37.5 (3.5-71.2); P = 0.153]. Estimated survival was not statistically different between females and males [log-rank χ2 = 0.6, P = 0.442; 95% confidence interval (CI) 110.7-207.3]. At Cox's regression analysis, gender did not impact overall survival (hazard ratio 0.8; 95% CI 0.6-1.3; P = 0.450). Estimated freedom from TEVAR-related reinterventions was not statistically different between females and males (log-rank χ2 = 0.4, P = 0.837; 95% CI 187.8-219.3).

Conclusions: Female gender itself was not associated with worse 30-day mortality and late survival than males with similar access vessel complication as well as TEVAR-related reintervention rate.

Keywords: Access complication; Aorta-related mortality; Female gender; Freedom from reintervention; Thoracic endovascular aortic repair.

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Figures

None
Graphical abstract
Figure 1:
Figure 1:
Consort diagram of all thoracic aortic diseases treated with thoracic endovascular aortic repair for descending diseases (2005–2023, n = 655).
Figure 2:
Figure 2:
Kaplan–Meier estimate of freedom from TEVAR-related reintervention stratified by the underlying aortic disease. TEVAR: thoracic endovascular aortic repair.
See this image and copyright information in PMC

References

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