Endovascular Aortic Repair of Thoracic Aortic Disease: Early and 1-Year Results From a German Multicenter Registry

Purpose: To report a "real-world" multicenter experience in the use of thoracic endovascular aortic repair (TEVAR) for diseases of the descending thoracic aorta. Methods: A prospective, multicenter, German TEVAR Registry was established in October 2008 and enrolled 191 patients (134 men; mean age 64.5 +/- 13.2 years) from 7 hospitals up to March 2011. Stent-graft implantation was performed for Stanford type B aortic dissection (104, 55.3%), true thoracic aortic aneurysm (91, 48.7%), intramural hematoma (20, 10.7%), penetrating aortic ulcer (16, 8.6%), and traumatic aortic rupture (6, 3.2%). Results: Per patient, a mean of 1.2 +/- 0.7 stent-grafts were implanted. Technical success was 92.1% (164/178); 15 (8.5%) endoleaks (types I-III) were reported. Intervention duration was a mean 107 +/- 122 minutes. During the hospital stay, stroke occurred in 3.9% of patients (7/180) and paraplegia in 1.7% (3/180). Reintervention was performed in 3.3% (6/180). The mortality was 5.5% (10/181) in-hospital and 5.6% at 30 days. The mean follow-up was 24.5 +/- 27.7 months. The Kaplan-Meier estimates of 1-year reintervention and death rates were 7.2% and 11.4%, respectively. Conclusion: In this real-world TEVAR registry for acute or chronic descending aortic diseases, technical success was high and the short-term complication rate was acceptable. However, the high reintervention rate observed in the present study mandates thorough clinical and imaging follow-up after an initially successful procedure.