Gender Related Access Complications After TEVAR: Analysis from the Retrospective Multicentre Cohort GORE® GREAT Registry Study.

Abstract

OBJECTIVE:

The Global Registry for Endovascular Aortic Treatment (GREAT), a retrospective sponsored registry, was queried to determine the incidence and identify potential predictors of access related complications after TEVAR.

METHODS:

This is a multicentre, observational cohort study. For the current study, all patients were treated only with the Conformable GORE® TAG® Thoracic Endoprosthesis and GORE® TAG® Thoracic Endoprosthesis devices for any kind of thoracic aortic disease. All serious adverse events within 30 days of the procedure were documented by sites. The following were considered access related complications: surgical site infection, pseudoaneurysm, avulsion, dissection, arterial bleeding, access vessel thrombosis/occlusion, seroma, and lymphocoele.

RESULTS:

A total of 887 patients was analysed: most of the cases had an operative indication for TEVAR of degenerative atherosclerotic aneurysm (n = 414, 46.7%) and type B dissection (n = 270, 30.4% either complicated or uncomplicated). Two hundred and ninety-five patients (33.3%) were female. The overall access related complication rate was 2.8% (n = 25): 4.7% (n = 14) in women and 1.8% (n = 11) in men (p = .013). After adjustment for age, urgency, device diameter, introducer sheath (≥24Fr vs. ≤ 24Fr), access vessel diameters, and access method, female gender was significantly associated with the risk of access complications (OR 2.85; p = .038). Brachial artery for access was also found to be an independent predictor of access related complications (OR 8.32; p < .001).

CONCLUSION:

This analysis suggests that women may have a higher access related complication rate after TEVAR, irrespective of the clinical setting, type of aortic disease, and device sizing.

• Authors: Chiara Lomazzi, Chiara Mascoli, Hector W L de Beaufort, Piergiorgio Cao, Fred Weaver, Ross Milner, Mark Fillinger, Eric Verhoeven, Viviana Grassi, Mauro Gargiulo, Santi Trimarchi, Gabriele Piffaretti, GREAT participants
• Journal: European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery (Eur J Vasc Endovasc Surg) Vol. 60 Issue 2 Pg. 203-209 (Aug 2020) ISSN: 1532-2165 [Electronic] England
• PMID: 32402803 (Publication Type: Comparative Study, Journal Article, Multicenter Study, Observational Study)
• Copyright: Copyright © 2020 European Society for Vascular Surgery. Published by Elsevier B.V. All rights reserved.

Topics

• Aged
• Aged, 80 and over
• Aorta, Thoracic (surgery)
• Blood Vessel Prosthesis
• Blood Vessel Prosthesis Implantation (adverse effects, instrumentation)
• Catheterization, Peripheral (adverse effects)
• Endovascular Procedures (adverse effects, instrumentation)
• Europe (epidemiology)
• Female
• Humans
• Incidence
• Male
• Middle Aged
• Postoperative Complications (diagnostic imaging, epidemiology)
• Prosthesis Design
• Registries
• Retrospective Studies
• Risk Assessment
• Risk Factors
• Sex Distribution
• Sex Factors
• Stents
• Time Factors
• Treatment Outcome