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Incidence and predictors of neurological complications following thoracic endovascular aneurysm repair in the Global Registry for Endovascular Aortic Treatment

European Journal of Vascular and Endovascular Surgery Jun 27, 2019

Piazza M, et al. - Researchers examined the Global Registry for Endovascular Aortic Treatment for the incidence and predictive factors for early and midterm neurological complications following thoracic endovascular repair (TEVAR). Respondents were 833 patients, including 28 with arch aneurysms (3.4%), 329 with descending thoracic aneurysms (39.5%), 273 with type B dissections (32.8%), and 203 (24.4%) with other thoracic pathologies. Outcomes revealed an overall low rate of neurological complication after TEVAR for isolated thoracic aortic pathologies. In total, 13 early cerebrovascular accidents (CVAs) (1.5%) were reported and a four-year freedom from CVA rate of 96.3% was identified. The only independent predictor of early CVA was aortic arch aneurysm, as seen on multivariable analysis. Midterm ischemic CVAs could be independently predicted via left subclavian artery coverage and hypercholesterolemia. Fifteen (1.8%) early spinal cord injuries (SCI) and a four-year freedom from SCI rate of 97.8% were observed. An independent predictor of SCI at four years is length of coverage.

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