[Evolution of endovascular treatment compared with medical and surgical treatment in patients with aortic syndrome type B].

Introduction: Surgical treatment is accepted as conventional treatment of patients with acute aortic syndrome associated to ischemic complications. Promising results of thoracic endovascular aortic repair (TEVAR) has expanded its indication to a variety of thoracic aorta pathologies.

Objectives: The objective of this study was to evaluate the safety and efficacy of TEVAR during the in-hospital period and at mid-term follow-up, and compare with medical and surgical treatment in patients who presented with acute aortic syndrome (AAS) type B.

Material And Methods: Of 113 patients that fulfilled the inclusion criteria, 58 underwent endovascular treatment (Group 1), 34 had medical treatment (Group 2), and 21 had surgical treatment (Group 3).

Results: Global and cardiovascular in-hospital mortality was superior in Group 3 (p = 0.0001). Mean follow-up was 30.4 ± 12.2 months. The survival rate free from cardiovascular death was 92.5, 60.5, and 42.9, in Group 1, 2, and 3, respectively, at 36 months.

Conclusions: Our results suggest that endovascular treatment is feasible, safe, and associated with a reduction of in-hospital and mid-term major adverse cardiovascular events, and superior survival rate compared with surgical and medical treatment.