Endovascular vs. Open Repair of Intact Descending Thoracic Aortic Aneurysms

For the management of descending thoracic aortic aneurysms, open surgical repair and thoracic endovascular aortic repair (TEVAR) are options for therapy. We performed a retrospective study of patients with intact descending thoracic aortic aneurysms who underwent TEVAR or open surgical repair using...

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Bibliographic Details
Published in:Journal of the American College of Cardiology 2019-02, Vol.73 (6), p.643-651
Main Authors: Chiu, Peter, Goldstone, Andrew B., Schaffer, Justin M., Lingala, Bharathi, Miller, D. Craig, Mitchell, R. Scott, Joseph Woo, Y., Fischbein, Michael P., Dake, Michael D.
Format: Article
Language:English
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Summary:For the management of descending thoracic aortic aneurysms, open surgical repair and thoracic endovascular aortic repair (TEVAR) are options for therapy. We performed a retrospective study of patients with intact descending thoracic aortic aneurysms who underwent TEVAR or open surgical repair using a regression discontinuity design and propensity score matching in the Medicare database. There were 1,235 open surgical repair patients matched to 2,470 TEVAR patients. Odds of perioperative mortality were greater for open surgical repair; restricted mean survival time difference favored TEVAR. TEVAR should be considered first line for repair of intact descending thoracic aortic aneurysms in Medicare beneficiaries.
ISSN:0735-1097
1558-3597
DOI:10.1016/j.jacc.2018.10.086