Key result
Thoracic endovascular aortic repair was associated with higher long-term mortality compared to open surgical repair for descending thoracic aortic aneurysm (HR 1.30; 95% CI 1.05-1.59; P=0.01).
Why the study?
Although TEVAR has gained preference over OSR for descending thoracic aortic aneurysm, contemporary comparative outcomes between the two interventions needed evaluation.
Does thoracic endovascular aortic repair improve survival compared to open surgical repair in patients with descending thoracic aortic aneurysm?
Comparison
TEVAR vs OSR
Design
Systematic review and meta-analysis of propensity-matched and risk-adjusted studies
Authors
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Supports preferring open repair when feasible in descending thoracic aortic aneurysm; challenges TEVAR preference and extends durability comparisons.
Meta-Analysis (n=14,873)
Does thoracic endovascular aortic repair improve survival compared to open surgical repair in patients with descending thoracic aortic aneurysm?
Hazard Ratio: 1.3 (95% CI 1.05–1.59)
p-value: p=0.01
Although operative mortality is comparable, TEVAR is associated with higher long-term mortality than open surgical repair in patients with descending thoracic aortic aneurysm, suggesting a need to reconsider open surgical repair indications.
Iyanna et al. (2024) conducted a meta-analysis in Descending thoracic aortic aneurysm (DTA) (n=14,873). Thoracic endovascular aortic repair (TEVAR) vs. Open surgical repair (OSR) was evaluated on Overall long-term mortality (HR 1.30, 95% CI 1.05-1.59, p=0.01). Thoracic endovascular aortic repair was associated with higher long-term mortality compared to open surgical repair for descending thoracic aortic aneurysm (HR 1.30; 95% CI 1.05-1.59; P=0.01).
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