Influence of sex after elective thoracic endovascular aortic repair

Objectives: This study aims to evaluate the early and mid-term outcomes of sex influence after elective thoracic endovascular aortic repair (TEVAR).Patients and methods: A total of 69 patients (46 males, 23 females; mean age: 61.2±16.0years; range, 42 to 86 years) who underwent an elective TEVAR between January 2019 and January 2021 were retrospectively analyzed.The patients were divided into two groups according to sex.All procedures were performed by the same endovascular team.Mainly Medtronic's Valiant® and Lifetech's Ankura® thoracic endografts were used.Technical success, early (30-day) morbidity and mortality, mid-term mortality, and secondary intervention rates were evaluated.Results: Early mortality was 4.35% for both sex (p=0.975).In the early postoperative period, no complications requiring any reintervention were encountered.Eighteen patients experienced intentional left subclavian artery coverage.Prophylactic carotid-subclavian bypass was performed in two males and one female before the TEVAR procedure.Delayed left subclavian artery revascularization was performed in one male patient due to left arm ischemia.There was no other neurovascular complication.In the follow-up period (13±6.9months), reintervention was performed in one female and two male patients for type 1 endoleak and one Petticoat procedure two months after the first TEVAR.There was only one late mortality due to retrograde type A dissection at the postoperative third month.Conclusion: Our findings suggest that TEVAR in female sex is safe and effective with successful early morbidity and mortality results.The sex difference does not affect the early and mid-term outcomes of elective TEVAR.