Abstract
(1) Background: The risk factors of peri-intervention stroke (PIS) in thoracic endovascular aortic repair (TEVAR) and endovascular abdominal aortic repair (EVAR) are different. This study aimed to compare the risks of PIS in both interventions. (2) Methods: Patients who had suffered a PIS related to TEVAR or EVAR from January 2008 to June 2015 in Songklanagarind Hospital were selected as the cases, while patients who had not suffered PIS were randomly selected to create a 1:4 case: control ratio for analysis. The associations between the factors from pre- to post-intervention and PISs in TEVAR or EVAR cases were analyzed by univariable analysis (p < 0.1). The independent risks of PIS were identified by multivariable analysis and presented in odds ratios (p < 0.05). (3) Results: A total of 17 (2.2%) out of 777 patients who had undergone TEVAR or EVAR experienced PIS, of which 9/518 (1.7%) and 8/259 (3.1%) cases were in TEVAR and EVAR groups, respectively. PIS developed within the first 24 h in nine (52.9%) cases. Large vessel ischemic stroke or watershed infarctions were the most common etiologies of PIS. The independent risks of PIS were the volume of intra-intervention blood loss (1.99 (1.88–21.12), p < 0.001) in the TEVAR-related PIS, and intervention time (2.16 (1.95–2.37), p = 0.010) and post-intervention hyperglycemia (18.60 (1.60–216.06), p = 0.001) in the EVAR-related PIS. There were no differences in the rate of PIS among the operators, intervention techniques, and status of the interventions performed. (4) Conclusion: The risks of PIS in TEVAR or EVAR in our center were different and possibly independent of the operator expertise and intervention techniques.
Highlights
There is currently a growing number of minimally invasive surgeries, for example, body tissue intervention for performing a tissue biopsy or treatment and endovascular intervention (EVI) for treating vascular pathologies
EVI causes less body tissue injury compared with conventional surgery, its associated vascular complications, strokes, remain a critical concern pending an effective procedure for prevention
In which the variations in the levels of various tissue thrombophilic factors induced by surgical injury during or post-operation are attributed as a cause of stroke [1,2], a pre-existing atheromatic plaque plus manipulation of the device wire within the vascular lumen can lead to the increased risks of peri-intervention thromboembolism [3]
Summary
There is currently a growing number of minimally invasive surgeries, for example, body tissue intervention for performing a tissue biopsy or treatment and endovascular intervention (EVI) for treating vascular pathologies. EVI causes less body tissue injury compared with conventional surgery, its associated vascular complications, strokes, remain a critical concern pending an effective procedure for prevention. In which the variations in the levels of various tissue thrombophilic factors induced by surgical injury during or post-operation are attributed as a cause of stroke [1,2], a pre-existing atheromatic plaque plus manipulation of the device wire within the vascular lumen can lead to the increased risks of peri-intervention thromboembolism [3]. Dislodgement of an aortic atheroma caused by the intravascular manipulation of the device while performing an aortic EVI, e.g., thoracic endovascular aortic repair (TEVAR) or endovascular abdominal aortic repair (EVAR), can result in an aorto-cerebral embolism, a common etiology of peri-intervention stroke (PIS) [4,5,6]. Despite the limited number of study cases and a single-center study, in which sharing of operators’ expertise and techniques is common, we believe that our study is useful in demonstrating the true risks of PIS in each intervention
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
