Impact on outcomes by measuring tortuosity with reporting standards for thoracic endovascular aortic repair

Chun Ku Chen, I. Ping Liang, Hsiao Ting Chang, Wei Yuan Chen, I. Ming Chen, Mei Han Wu, Ming Huei Sheu, Chun Che Shih

Research output: Contribution to journalArticlepeer-review

38 Citations (Scopus)


Objective In this study, we assessed the association between the tortuosity of the thoracic aorta as measured by the reporting standards for thoracic endovascular aortic repair (TEVAR), described by the Society for Vascular Surgery, and midterm outcomes after TEVAR for atherosclerotic aneurysms

Results The mean follow-up period was 29 ± 26 months. During this period, endoleaks occurred in 19 patients. Patients in the high-tortuosity group were at greater risk for endoleaks (odds ratio, 9.95; 95% confidence interval, 2.06-48.1; P =.004) and stroke (odds ratio, 13.2; 95% confidence interval, 1.03-169; P =.047) than those in the low-tortuosity group. The overall survival at 1, 3, and 5 years was 73%, 69%, and 63%, respectively, for the high-tortuosity group and 92%, 92%, and 86%, respectively, for the low tortuosity group.

Methods We analyzed 77 consecutive patients who underwent TEVAR for atherosclerotic aneurysms from November 2006 through May 2013 in a single institution. The preoperative aortic tortuosity index (TI) was calculated by computed tomography aortography, and patients were divided into low-tortuosity (TI ≤1.29) and high-tortuosity (TI > 1.29) groups. The relationships between TI and the occurrence of endoleaks, complications, and survival were analyzed

Conclusions Our findings demonstrated that high tortuosity of the thoracic aorta is associated with higher rates of endoleaks and lower survival in patients undergoing TEVAR for atherosclerotic aneurysms. Patients with aneurysms in a highly tortuous aorta may therefore need greater attention in preoperative planning, perioperative procedures, and follow-up examinations.

Original languageEnglish
Pages (from-to)937-944
Number of pages8
JournalJournal of Vascular Surgery
Issue number4
Publication statusPublished - Oct 1 2014
Externally publishedYes

ASJC Scopus subject areas

  • Surgery
  • Cardiology and Cardiovascular Medicine


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