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Background and Aims: Thoracic Endovascular Repair (TEVAR) is the preferred option for managing aneurysm disease of the Descending Thoracic Aorta (DTAA) and complications of acute Thoracic Aortic Dissection (TAD). We describe our early Northeast Scotland 5-year experience of TEVAR. Methods: Retrospective analysis of all emergency and elective TEVAR from January 2012 – July 2017 was performed. Patient demographics, presentation, imaging, operative details, survival status and surveillance CTA status were recorded. Technical success was defined as exclusion of the DTAA without Type 1 endoleak or conversion to open repair or sealing of the proximal entry in acute dissection. Results: We identified 10 (M: F ratio of 4:1, mean age of 67 years old; standard deviation 17 years) with a technical success of 100%. 7(70%) cases were performed as emergency (3 symptomatic dissection, 1 rupture dissection, 1 rupture aneurysm, 1 aortic transection, 1 rupture penetrating aortic ulcer). Postoperative SCI was not observed. 1 (10%) patient had prophylactic spinal cerebrovascular fluid (CSF) drainage. 3 (30%) patient had coverage of the left subclavian artery (LSA). Mean follow-up was 12 months.30-day mortality was zero, mortality at follow up was 10% (n=1). In hospital, post-operative morbidity was 30%. Endoleak was noted in 2 (20%) patients at follow up. Conclusion: This study demonstrates the relatively high incidence of unscheduled admission and treatment for this pathology and encouraging early results. Prophylactic measure for SCI remains a topic for debate.

The Northeast Scotland’s 5-year TEVAR Experience