Endovascular treatment of descending thoracic aortic pathology: results of the Regis-TEVAR study.

Abstract Background Endovascular techniques have become an essential tool for treatment of thoracic aortic pathology (TEVAR). The objetive of this study is to analyze indications and results of TEVAR in Vascular Surgery Units, through a retrospective and multicentric national registry called Regis-TEVAR. Methods From 2012 to 2016, a total of 287 patients from 11 Vascular Surgery Units, treated urgently and electively, were recruited consecutively. The primary variables analyzed are mortality, survival and reintervention rate. The indications for TEVAR were also analyzed: aortic dissections, thoracic aneurysms, traumatisms and intramural hematomas or penetrating ulcers, as well as results and postoperative complications according to each indication. Results Of the 287 TEVAR performed (239 males, mean age 64.1 ± 14.1 years), 155 were due to aortic aneurysm (54%), 90 type B aortic dissection (31.4%), 36 traumatic aortic rupture (12. 5%) and 6 penetrating ulcers or intramural hematomas (2.1%). Overall mortality at 30 days was 11.5% (18.5% in urgent and 5.3% in elective), being higher in dissections (13.3%). The median actuarial survival was 73% at 4 years. The stroke rate was 3.1% and the rate of spinal cord ischemia 4.9%. Aortic reoperations were necessary in 23 patients (8.1%). Conclusions This registry provides complete and reliable information on real clinical practice of TEVAR in Spain, with results similar to international series of open surgery. According to these data, TEVAR can be performed with acceptable morbidity and mortality and with low rates of postoperative complications.