{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T15:30:33Z","timestamp":1761060633003},"reference-count":40,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2018,8,20]],"date-time":"2018-08-20T00:00:00Z","timestamp":1534723200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2018,8,20]],"date-time":"2018-08-20T00:00:00Z","timestamp":1534723200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2019,1,15]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Surgical decision making remains difficult in several patients with aneurysmal disease of the descending thoracic (DT) or thoracoabdominal (TA) aorta. Despite previous studies that have investigated aneurysms treated non\u2010operatively using a prospective growth analysis, completeness and accuracy of follow\u2010up were inconsistent. We aim to describe the survival and freedom from adverse aortic events in patients with DT and TA who did not undergo operative repair.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This is a single\u2010center retrospective analysis of all patients with either a descending degenerative atherosclerotic or dissection\u2010related DT or TA aortic lesion who were treated non\u2010operatively from April 2002 to December 2016. We studied patients who did not undergo operative repair of descending degenerative atherosclerotic or dissection\u2010related DT or TA aortic lesion. Primary end points were overall survival and freedom from aortic\u2010related mortality (ARM).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 315 patients diagnosed with DT or TA disease, 56 (18%) did not undergo surgical repair. Mean aneurysm diameter was 65\u00a0mm\u2009\u00b1\u200915 (range 50\u2013120; IQR 5.4\u20137.15). Extent of the aortic aneurysms was DT in 36 (11%) patients and TA in 20 (6%). Median duration of follow\u2010up was 12\u00a0months (range 1\u2013108; IQR 3\u201336). Over the course of the study, 41 (73%) patients died for an overall survival rate of 53%\u2009\u00b1\u20097 at 1 year (95% CI 40\u201365) and 23%\u2009\u00b1\u20097 at 3 year (95% CI 17\u201342.5). Aortic\u2010related mortality was 27% (<jats:italic>n<\/jats:italic>\u2009=\u200915), significantly higher in patients with aneurysms\u2009\u2265\u200960\u00a0mm [<jats:italic>n<\/jats:italic>\u2009=\u200913, (39%) vs. <jats:italic>n<\/jats:italic>\u2009=\u20092, (9%); <jats:italic>P<\/jats:italic>\u2009=\u20090.025; OR\u2009=\u20095.04]. Overall, estimated freedom from ARM was 81%\u2009\u00b1\u20095.5 at 1 year (95% CI 68\u201389) and 66.5%\u2009\u00b1\u20099 at 3 year (95% CI 48\u201381). Only TA extent was independently associated with freedom from ARM during the follow\u2010up (<jats:italic>P\u2009<\/jats:italic>=\u20090.005; HR: 5.74; 95% CI 1.711\u201319.729).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Thoracoabdominal extent of the aneurysmal aortic disease is the most important predictor of ARM in unrepaired DT or TA aortic diseases. Mortality from aortic\u2010related events was significantly more premature than mortality from non\u2010aortic\u2010related mortality.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-018-4768-6","type":"journal-article","created":{"date-parts":[[2018,8,20]],"date-time":"2018-08-20T18:36:49Z","timestamp":1534790209000},"page":"273-281","update-policy":"http:\/\/dx.doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Outcomes Following Non\u2010operative Management of Thoracic and Thoracoabdominal Aneurysms"],"prefix":"10.1002","volume":"43","author":[{"given":"Gabriele","family":"Piffaretti","sequence":"first","affiliation":[{"name":"Vascular Surgery\u2013Department of Medicine and Surgery, Circolo University Teaching Hospital University of Insubria School of Medicine Via Guicciardini 9 21100 Varese 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Cristina","family":"Cervarolo","sequence":"additional","affiliation":[{"name":"Vascular Surgery\u2013Department of Medicine and Surgery, Circolo University Teaching Hospital University of Insubria School of Medicine Via Guicciardini 9 21100 Varese Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Walter","family":"Dorigo","sequence":"additional","affiliation":[{"name":"Vascular Surgery, Department of Cardiothoracic and Vascular Surgery, Careggi University Teaching Hospital University of Florence School of Medicine Florence Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrizio","family":"Castelli","sequence":"additional","affiliation":[{"name":"Vascular Surgery\u2013Department of Medicine and Surgery, Circolo University Teaching Hospital University of Insubria School of Medicine Via Guicciardini 9 21100 Varese 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