US Trends in Thoracic Aneurysm Repair. Karen L. Walker MS Jonathan J. Shuster PHD Thomas M. Beaver MD, MPH Division of Thoracic and Cardiovascular Surgery Division of Biostatistics University of Florida College of Medicine Gainesville, Florida. Objective.
Karen L. Walker MS Jonathan J. Shuster PHD Thomas M. Beaver MD, MPH
Division of Thoracic and Cardiovascular Surgery
Division of Biostatistics
University of Florida College of Medicine Gainesville, Florida
National practice patterns for thoracic aneurysm repair are largely unknown because the US does not have a thoracic aneurysm endovascular repair registry.
The National Inpatient Sample was employed to determine the effects of the 2005 FDA approval of thoracic aneurysm endografts on the surgical management of patients with thoracic aneurysms.
20% stratified sample of US hospital discharges
8 million hospital discharges
Can be weighted to generate national estimates
Can be used to assess in-hospital complications, mortality and outcomes.
Cannot be used to assess long-term outcomes.
An increase in diagnosis of Thoracic aneurysms followed introduction of 16 slice CT scanners in 2003
An increased overall repair rate of thoracic aneurysms followed 2005 FDA approval of thoracic endografts (TEVAR).
Increased adoption of Thoracic endograft repair may follow previous trends in Abdominal endograft repair (EVAR).
TEVAR (Thoracic EndoVascular Aortic Repair) patients were older with more comorbidities, but had shorter LOS, fewer complications and decreased mortality.
TEVAR has been rapidly adopted in the US resulting in increased treatment of thoracic aortic aneurysms.
Trends in abdominal aneurysm repair may foreshadow future trends in thoracic aneurysm repair.
Despite older age and comorbidities, TEVAR had better outcomes and shorter hospital stays.
Vigilant surveillance of TEVAR patients is warranted because the long-term outcomes are unknown.