Nationwide outcomes of endovascular thoracoabdominal aortic aneurysm repair
Yu, Harry H.Y. ; Asciutto, Giuseppe LU ; Dias, Nuno V. LU
; Wanhainen, Anders
; Karelis, Angelos
LU
; Sonesson, Björn
LU
and Mani, Kevin
(2026)
In British Journal of Surgery
113(4).
- Abstract
Background: Complex endovascular repair has emerged as a minimally invasive alternative for thoracoabdominal aortic aneurysms (TAAAs). The aim of this study was to assess the short- and mid-term outcomes of endovascular TAAA repair in Sweden. Methods: All endovascular TAAA repairs performed during 2018–2023 were identified in the Swedish Vascular (Swedvasc) Registry. Patient characteristics, operative details, and outcomes were analysed. The primary outcome was survival; secondary outcomes included complications and thoracoabdominal aortic life-altering events (TALEs). Predictors of mid-term outcomes were assessed in multivariable analysis. Results: Some 339 patients were treated for TAAAs, which included 476 repairs (366 elective... (More)
Background: Complex endovascular repair has emerged as a minimally invasive alternative for thoracoabdominal aortic aneurysms (TAAAs). The aim of this study was to assess the short- and mid-term outcomes of endovascular TAAA repair in Sweden. Methods: All endovascular TAAA repairs performed during 2018–2023 were identified in the Swedish Vascular (Swedvasc) Registry. Patient characteristics, operative details, and outcomes were analysed. The primary outcome was survival; secondary outcomes included complications and thoracoabdominal aortic life-altering events (TALEs). Predictors of mid-term outcomes were assessed in multivariable analysis. Results: Some 339 patients were treated for TAAAs, which included 476 repairs (366 elective repairs and 110 emergency repairs) across 11 centres (94% concentrated in 5 centres). Elective patients (235 patients; mean diameter 64 mm) had 30-day, 90-day, and 1-year mortality of 2.6%, 3.5%, and 12.4% respectively. Major complications, vascular complications, and TALEs occurred in 16.2%, 9.8%, and 14% respectively. The use of prophylactic spinal drainage declined over time (from 68% to 14%) and the incidence of spinal cord ischaemia declined over time (from 20% to 2.3%). Mean(s.e.) 1-year and 4-year Kaplan–Meier survival estimates were 89.3%(2.1%) and 73.5%(3.7%) respectively. Emergency patients (104 patients; mean diameter 73 mm) had 30-day, 90-day, and 1-year mortality of 12.5%, 17.6%, and 26.9% respectively. Major complications, vascular complications, and TALEs occurred in 20.2%, 12.5%, and 24% respectively. Mean(s.e.) 1-year and 4-year Kaplan–Meier survival estimates were 75.2%(4.3%) and 56.5%(6.2%) respectively. Perioperative myocardial infarction was the strongest predictor of 1-year mortality after both elective and emergency repair. Conclusion: Endovascular TAAA repair in Sweden is associated with significant complication rates, but acceptable mid-term survival. Further research should focus on perioperative refinements, especially with regard to preserving organ function.
(Less)
- author
- Yu, Harry H.Y.
; Asciutto, Giuseppe
LU
; Dias, Nuno V.
LU
; Wanhainen, Anders
; Karelis, Angelos
LU
; Sonesson, Björn
LU
and Mani, Kevin
- organization
- publishing date
- 2026-04
- type
- Contribution to journal
- publication status
- published
- subject
- in
- British Journal of Surgery
- volume
- 113
- issue
- 4
- publisher
- Oxford University Press
- external identifiers
-
- scopus:105036169867
- pmid:41885956
- ISSN
- 0007-1323
- DOI
- 10.1093/bjs/znag035
- language
- English
- LU publication?
- yes
- id
- 381faa94-3ee3-48b6-9af0-3eb0e8baa33c
- date added to LUP
- 2026-06-24 11:48:42
- date last changed
- 2026-09-03 23:50:23
@article{381faa94-3ee3-48b6-9af0-3eb0e8baa33c,
abstract = {{<p>Background: Complex endovascular repair has emerged as a minimally invasive alternative for thoracoabdominal aortic aneurysms (TAAAs). The aim of this study was to assess the short- and mid-term outcomes of endovascular TAAA repair in Sweden. Methods: All endovascular TAAA repairs performed during 2018–2023 were identified in the Swedish Vascular (Swedvasc) Registry. Patient characteristics, operative details, and outcomes were analysed. The primary outcome was survival; secondary outcomes included complications and thoracoabdominal aortic life-altering events (TALEs). Predictors of mid-term outcomes were assessed in multivariable analysis. Results: Some 339 patients were treated for TAAAs, which included 476 repairs (366 elective repairs and 110 emergency repairs) across 11 centres (94% concentrated in 5 centres). Elective patients (235 patients; mean diameter 64 mm) had 30-day, 90-day, and 1-year mortality of 2.6%, 3.5%, and 12.4% respectively. Major complications, vascular complications, and TALEs occurred in 16.2%, 9.8%, and 14% respectively. The use of prophylactic spinal drainage declined over time (from 68% to 14%) and the incidence of spinal cord ischaemia declined over time (from 20% to 2.3%). Mean(s.e.) 1-year and 4-year Kaplan–Meier survival estimates were 89.3%(2.1%) and 73.5%(3.7%) respectively. Emergency patients (104 patients; mean diameter 73 mm) had 30-day, 90-day, and 1-year mortality of 12.5%, 17.6%, and 26.9% respectively. Major complications, vascular complications, and TALEs occurred in 20.2%, 12.5%, and 24% respectively. Mean(s.e.) 1-year and 4-year Kaplan–Meier survival estimates were 75.2%(4.3%) and 56.5%(6.2%) respectively. Perioperative myocardial infarction was the strongest predictor of 1-year mortality after both elective and emergency repair. Conclusion: Endovascular TAAA repair in Sweden is associated with significant complication rates, but acceptable mid-term survival. Further research should focus on perioperative refinements, especially with regard to preserving organ function.</p>}},
author = {{Yu, Harry H.Y. and Asciutto, Giuseppe and Dias, Nuno V. and Wanhainen, Anders and Karelis, Angelos and Sonesson, Björn and Mani, Kevin}},
issn = {{0007-1323}},
language = {{eng}},
number = {{4}},
publisher = {{Oxford University Press}},
series = {{British Journal of Surgery}},
title = {{Nationwide outcomes of endovascular thoracoabdominal aortic aneurysm repair}},
url = {{http://dx.doi.org/10.1093/bjs/znag035}},
doi = {{10.1093/bjs/znag035}},
volume = {{113}},
year = {{2026}},
}