A Decade of EVAR in New York State: Volumes, Outcomes, and Implications for the Dissemination of Endovascular Technology

Abstract

Query of New York Statewide Planning and Research Cooperative System (SPARCS) database between 2005 and 2014. The query identified 1838 patients who underwent thoracic endovascular aortic repair (TEVAR) for aortic dissection (n = 334), nonruptured aneurysm (n = 1278), and ruptured aneurysms (n = 226). TEVAR implantation significantly increased over the 10 years in all groups with a recent increase for dissection. Between 2005 and 2007, patients were more likely to be treated at high-volume facilities (>17 per year) and by high-volume surgeons (>5 per year), but since 2011, about half of the patients underwent TEVAR by low-volume surgeons (<3 per year). Neither surgeon nor hospital volume were associated with clinical outcome. Comparable results were obtained with TEVAR across hospital and surgeon volume strata. These findings have implications for credentialing and regionalization of TEVARs and other vascular procedures.