Early Outcomes of TEVAR: Spinal Cord Ischemia and Reintervention Rates in a Single-Center Study

Objective: Data based on the technical successes of endovascular procedures and certain advantages over open surgery have recently led to their being the preferred treatment protocol for thoracic aortic interventions. The aim of this study is to present the single-center results, especially focusing on spinal cord ischemia and reintervention, and to examine their relationships with various variables. Methods: Data from patients who underwent TEVAR between February 2012 and August 2023 were retrospectively collected. Primary outcomes were spinal cord ischemia and early reinterventions. Secondary outcomes included stroke, arm ischemia, and 30-day mortality outcomes. Results: In the dataset of 146 patients, 116 (79.45%) were male, with an average age of 63.23 ± 12.50. Among the complications, postoperative stroke was observed in 20 patients (13.7%), and arm ischemia, likely due to occlusion of the subclavian artery, was observed in 10 patients (6.84%). Spinal cord ischemia was observed in 11 patients (7.5%), while TEVAR-related reintervention was required in 38 patients (26%). No significant relationship was found between SCI and the variables (p-value > 0.05); however, a statistically significant relationship was observed between reinterventions and smoking, diabetes, and lesions located in the distal zone (p-value < 0.05). Conclusions: This study has demonstrated that the risk of reintervention is increased in cases with a history of diabetes mellitus, smoking, and aortic pathologies located in the distal thoracic zone. However, the current findings need to be supported by larger randomized multicenter studies.