SHORT- AND MID-TERM OUTCOMES OF TEVAR IN DESCENDING THORACIC AORTIC PATHOLOGIES: INSIGHTS FROM A FRENCH NATIONWIDE COHORT
Author(s)
Corinne Emery, MS1, Elodie Torreton, MS2, Mickaël Palmier, MD, PhD3, Romain Chauvet, MD4, Claire Xylinas, PharmD5, Lucie de Léotoing, PharmD6.
1CEMKA, bourg la reine, France, 2CEMKA, Bourg La Reine, France, 3Rouen University Hospital, Rouen, France, 4Limoges University Hospital, Limoges, France, 5W.L. Gore & Associates, Paris, France, 6Market Access Strategy, W.L. Gore & Associates, Paris, France.
1CEMKA, bourg la reine, France, 2CEMKA, Bourg La Reine, France, 3Rouen University Hospital, Rouen, France, 4Limoges University Hospital, Limoges, France, 5W.L. Gore & Associates, Paris, France, 6Market Access Strategy, W.L. Gore & Associates, Paris, France.
OBJECTIVES: Thoracic endovascular aortic repair (TEVAR) has become the standard treatment for descending thoracic aortic pathologies, including aneurysms, dissections and traumatic ruptures. However, nationwide data reflecting real-world outcomes in an unselected population remain limited. The objective of this study was to evaluate short- and mid-term outcomes of TEVAR procedures performed in France.
METHODS: This retrospective observational study was conducted using the French national healthcare database. All adult patients who underwent an index TEVAR procedure between January 2018 and December 2023 were included. Patients were identified using implant codes associated with TEVAR procedure codes and classified according to the underlying indication: aneurysm, dissection or traumatic rupture. Demographic characteristics were described, and early postoperative outcomes, mortality and aortic reinterventions were analyzed for up to 5 years using Kaplan-Meier models.
RESULTS: A total of 5,527 patients were included over a six-year period: 49% were treated for aneurysm, 34% for dissection, 15% for traumatic rupture (2% unclassified). Mean age was 71.2 ± 10.8 years, 64.7 ± 12.8 years and 56.2 ± 20.3 years, respectively. Median length of index hospital stay was 7.0, 11.0 and 14.5 days, respectively. Thirty-day mortality rates were 7.4%, 7.2% and 15.5%, and neurological complications occurred in 12.8%, 12.7% and 19.2% of patients. At five years, mortality reached 29.7% in the aneurysm group, 21.3% in the dissection group and 30.9% in the traumatic rupture group. Aortic reintervention rates were 26.0%, 34.4% and 16.2%, respectively. Endovascular reinterventions accounted for 16.1%, 20.2% and 8.6%, while surgical conversions accounted for 11.3%, 18.4% and 8.7%, respectively.
CONCLUSIONS: This large nationwide study confirms the outcomes of TEVAR in the management of descending thoracic aortic disease in routine clinical practice. Comparisons across different indications should be interpreted with caution due to the heterogeneity in patient populations and clinical contexts underlying each indication.
METHODS: This retrospective observational study was conducted using the French national healthcare database. All adult patients who underwent an index TEVAR procedure between January 2018 and December 2023 were included. Patients were identified using implant codes associated with TEVAR procedure codes and classified according to the underlying indication: aneurysm, dissection or traumatic rupture. Demographic characteristics were described, and early postoperative outcomes, mortality and aortic reinterventions were analyzed for up to 5 years using Kaplan-Meier models.
RESULTS: A total of 5,527 patients were included over a six-year period: 49% were treated for aneurysm, 34% for dissection, 15% for traumatic rupture (2% unclassified). Mean age was 71.2 ± 10.8 years, 64.7 ± 12.8 years and 56.2 ± 20.3 years, respectively. Median length of index hospital stay was 7.0, 11.0 and 14.5 days, respectively. Thirty-day mortality rates were 7.4%, 7.2% and 15.5%, and neurological complications occurred in 12.8%, 12.7% and 19.2% of patients. At five years, mortality reached 29.7% in the aneurysm group, 21.3% in the dissection group and 30.9% in the traumatic rupture group. Aortic reintervention rates were 26.0%, 34.4% and 16.2%, respectively. Endovascular reinterventions accounted for 16.1%, 20.2% and 8.6%, while surgical conversions accounted for 11.3%, 18.4% and 8.7%, respectively.
CONCLUSIONS: This large nationwide study confirms the outcomes of TEVAR in the management of descending thoracic aortic disease in routine clinical practice. Comparisons across different indications should be interpreted with caution due to the heterogeneity in patient populations and clinical contexts underlying each indication.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
MT29
Topic
Clinical Outcomes, Medical Technologies, Real World Data & Information Systems
Disease
Cardiovascular Disorders (including MI, Stroke, Circulatory), Surgery