Sex Relater Outcomes After Endovascular Repair of Complex and Thoraco-Abdominal Aneurysms: The SERENA Study

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ID: 315717
2026
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Abstract
Abstract Background Short-term outcomes after complex abdominal aortic aneurysms (cAAAs) and thoraco-abdominals (TAAAs) appear to be worse in women, yet evidence is inconsistent regarding the role of female sex on long-term aortic events and mortality. Aims The aim of this study was to evaluate long-term outcomes after complex endovascular aortic repair according to sex. Methods Single-center, retrospective comparative cohort study. All patients undergoing complex endovascular repair for cAAAs or TAAAs between 2010–2023 were included. The primary endpoint was 5-year aortic-related events; secondary endpoints were 5-year mortality and reinterventions. Kaplan–Meier and Cox regression analysis were used to assessed long-term outcomes. Results A total of 403 patients (300 men and 103 women) with a mean age of 73.5 ± 7.3 years were included. Women had more TAAAs (52% vs. 21.6%; p < .0001) and more urgent repairs (21.8% vs. 9.6%; p=<.001). Thirty-day aortic related events and reintervention rates were higher in women (36.9% vs 17.3%; p = <.001% and 19.4% vs 9.7%; p=.037). Sex was an independent predictor of short-term aortic-related events (OR 2.10, 95% CI 1.08–4.11). Mean follow-up was 83.0 ± 3.4 months. The five year freedom from aortic-related events was 56% in women vs 79% in men (Log-Rank p =.<001), with sex being the strongest predictor of adverse aortic-related events (HR 2.31, 95% CI 1.30 - 4.11). The five-year overall survival rate was 53% in women vs 65.2% in men (log-rank p =.013). Female sex was independent risk-factor for long-term mortality (HR 1.71, 95% CI 1.15–2.54). Long-term reintervention rates were not significantly higher in women (Log-rank p = .073) and sex was not identified as an independent risk factor. Conclusion Female sex independently predicts both short- and long-term aortic-related events and mortality after complex EVAR.
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Authors R D’amico, A Wanhainen, K Mani, C F Prendes
Journal the british journal of surgery
Year 2026
DOI
10.1093/bjs/znag055.076
URL
https://doi.org/10.1093/bjs/znag055.076
Keywords Keywords not found

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