Advanced Age Linked to Poorer TEVAR Outcomes Despite Similar Aortic Remodeling, finds study

This meta-analysis included a total of 70 studies with 52,605 patients. Every study that was enrolled was regarded as being of high quality. In general, advanced age was substantially linked to increased risk of neurological complications (p = 0.006), particularly delirium (p = 0.009), spinal cord ischemia (p = 0.02), and overall neurological complications (p = 0.007), as well as postoperative mortality (p < 0.0001).

Interestingly, postoperative stroke patients were marginally older than non-stroke patients (p = 0.05). Nevertheless, there was no significant correlation between advanced age and a higher risk of postoperative overall complications (p = 0.59) or adverse aortic remodeling events (p = 0.34), such as false lumen dilatation (p = 0.52) or aortic dilatation (p = 0.43). Furthermore, the age difference between patients who suffered acute kidney damage following TEVAR and those who did not was statistically significant (p = 0.04).

Overall, while overall complications and aortic remodeling outcomes are similar, poor TEVAR outcomes, such as postoperative mortality and neurological complications, are linked to advanced age. Younger patients also had an even higher incidence of AKI. Before choosing to perform TEVAR on elderly patients, it is crucial to weigh the risks and benefits. For elderly patients, optimal peri-operative care should be created and offered.

Reference:

Li, J., Zou, P., Zhou, Y., Wang, J., Zhang, Y., Tan, X., Liu, M., & Hu, M. (2025). Advanced age is significantly associated with poor outcomes of thoracic endovascular aortic repair: a systematic review and meta-analysis. BMC Surgery, 25(1), 289. https://doi.org/10.1186/s12893-025-02990-x