Journal
JOURNAL OF CLINICAL MEDICINE
Volume 12, Issue 16, Pages -Publisher
MDPI
DOI: 10.3390/jcm12165213
Keywords
thoracic aorta; abdominal aorta; aortic aneurysm; endovascular repair; open repair; epidemiology; diagnosis-related groups
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Despite the development of fenestrated and branched endovascular aortic repair, the surgical management of thoraco-abdominal aortic aneurysms remains challenging in Switzerland. A study analyzed hospital incidence and mortality rates of TAAAs patients using nationwide administrative discharge data. The use of f/bEVAR in TAAA treatment increased significantly over the observed period, and it was associated with lower mortality rates for ruptured aneurysms.
Despite the development of fenestrated and branched endovascular aortic repair (f/bEVAR), the surgical management of thoraco-abdominal aortic aneurysms (TAAAs) remains a major challenge. The aim of this study was to analyse the hospital incidence and hospital mortality of patients treated for TAAAs in Switzerland. Secondary data analysis was performed using nationwide administrative discharge data from 2009-2018. Standardised incidence rates and adjusted mortality rates were calcu-lated. A total of 885 cases were identified (83.2% nonruptured (nrTAAA), 16.8% ruptured (rTAAA)), where 69.3% were male. The hospital incidence rate for nrTAAA was 0.4 per 100,000 women and 0.9 per 100,000 men in 2009, which had doubled for both sexes by 2018. For rTAAA, there was no trend over the years. The most common procedure was f/bEVAR (44.2%), followed by OAR (39.5%), and 9.8% received a hybrid procedure. There was a significant increase in endovascular procedures over time. The all-cause mortality was 7.1% with nrTAAA and 55% with rTAAA. The mortality was lower for rTAAA when f/bEVAR or hybrid procedures were used. A ruptured aneurysm and higher comorbidity were associated with higher hospital mortality. This study demonstrates that the treatment approach has changed significantly over the observed period. The use of f/bEVAR nearly tripled in nrTAAA and doubled in rTAAA during this decade.
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