O-063 - SEX RELATED OUTCOMES AFTER FENESTRATED AND BRANCHED ENDOVASCULAR AORTIC REPAIR

TOPIC:
Thoraco-abdominal Aortic Disease
AUTHORS:
Nana P. (Vascular Surgery Department, University Hospital of Larissa ~ Larissa ~ Greece) , Spanos K. (Vascular Surgery Department, University Hospital of Larissa ~ Larissa ~ Greece) , Behrendt C. (German Aortic Center, Department of Vascular Medicine ~ Hamburg ~ Germany) , Dakis K. (Vascular Surgery Department, University Hospital of Larissa ~ Larissa ~ Greece) , Brodis A. (Neurosurgery Department, University Hospital of Larissa ~ Larissa ~ Greece) , Kouvelos G. (Vascular Surgery Department, University Hospital of Larissa ~ Larissa ~ Greece) , Giannoukas A. (Vascular Surgery Department, University Hospital of Larissa ~ Larissa ~ Greece) , Kolbel T. (German Aortic Center, Department of Vascular Medicine ~ Hamburg ~ Germany)
Introduction:
Women present higher mortality and morbidity after endovascular aortic aneurysm repair. The aim of this study was to compare the mortality, morbidity and re-intervention rates at 30 days and 12 months, between males and females that were treated with fenestrated or branched endovascular aortic repair (F/BEVAR).
Methods:
The study was conducted according to the PRISMA guidelines, and the study protocol was registered to the PROSPERO (CRD42021273418). A systematic search of the English medical literature, via Ovid, using MEDLINE, EMBASE, and CENTRAL databases, until 30th July 2021, was performed. Observational studies published between 2000-2021, with more than 20 patients, reporting on sex specific outcomes [mortality, acute kidney injury (AKI), spinal cord ischemia (SCI), and re-intervention rates] after F/BEVAR were eligible. Individual studies were assessed for bias using the ROBINS-I and the quality of evidence using the GRADE tool. The primary outcome was the sex specific 30-day mortality, AKI, SCI, and reintervention and secondary, survival and freedom from re-intervention at 12-months after F/BEVAR. The outcomes were summarized as odds ratio (OR) with 95% confidence intervals (CI).
Results:
Four retrospective and one prospective study (2,421 patients; 26% females) were included. 30-day mortality was higher in females (OR, 2.65; 95% CI, 1.79, 3.92; Ι2=0%, Figure 1). AKI, SCI and re-intervention rates were similar between sexes at 30 days (OR, 1.45; 95% CI, 1.03, 2.03; Ι2=0%, OR 1.86; 95% CI, -1.27, 2.74; Ι2=38% and OR, 1.06; 95% CI, 0.66, 1.71; Ι2=0%). 12-month survival was lower in female patients (OR, 0.95; 95% CI, 0.91-0.99; Ι2=38%, Figure 2). When excluding the 30-day mortality, the 12-month survival showed no difference between males and females (OR, 0.99; 95% CI 0.95-1.02; Ι2=38%) while the 12-month freedom from re-intervention was similar between sexes (OR, 0.87; 95% CI, 0.75, 1.01; Ι2=0%).
Conclusion:
Females treated with F/BEVAR present worse survival at 12 months; a finding driven by the higher peri-operative mortality. Early morbidity and re-intervention rates seem to be comparable between sexes.
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