| Autor: |
Ulsaker H; Department of Circulation and Medical Imaging, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.; Norwegian National Research Centre for Minimally Invasive and Image-guided Diagnostics and Therapy, St. Olavs Hospital, Trondheim, Norway., Halvorsen H; Department of Surgery, Haukeland University Hospital, Bergen., Braaten AO; Department of Radiology, Haukeland University Hospital, Bergen., Dorenberg E; Department of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway., Rikken Lindberg B; Department of Cardiothoracic Surgery, Oslo University Hospital, Oslo,Norway., Nordhus KC; Department of Radiology, University Hospital of North Norway, Tromsø, Norway., Jakobsen Ø; Department of Cardiothoracic and Vascular Surgery, University Hospital of North, Norway., Brekken R; Norwegian National Research Centre for Minimally Invasive and Image-guided Diagnostics and Therapy, St. Olavs Hospital, Trondheim, Norway.; Department of Health Research, SINTEF, Trondheim, Norway., Seternes A; Department of Circulation and Medical Imaging, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.; Department of Surgery, St. Olavs University Hospital, Trondheim, Norway., Manstad-Hulaas F; Department of Circulation and Medical Imaging, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.; Norwegian National Research Centre for Minimally Invasive and Image-guided Diagnostics and Therapy, St. Olavs Hospital, Trondheim, Norway.; Department of Radiology, St. Olavs University Hospital, Trondheim, Norway. |
| Abstrakt: |
Objective : The multibranched off-the-shelf Zenith® t-Branch (Cook Medical, Bloomington, IN) device is commonly chosen for endovascular repair of thoracoabdominal aortic aneurysms. The aim of this study was to report early and mid-term outcomes in all patients treated with the t-Branch in Norway; Design and Methods : A retrospective multicenter study with Norwegian centers performing complex endovascular aortic repair was undertaken. T-Branch patients from 2014 to 2020 were included. All postoperative computed tomography angiography images were reviewed, and demographic, anatomical, perioperative and follow-up data were analyzed; Results: Seventy patients were treated in a single-step ( n = 55) or staged ( n = 15) procedure. Symptomatic presentation was seen in 20 patients, six of which had a contained rupture. Technical success was 87% ( n = 59), with failures caused by unsuccessful bridging of target vessels ( n = 4), target vessel bleeding ( n = 3), persisting type 1c endoleak ( n = 1) and t-Branch malrotation ( n = 1). 30-day mortality was 9% ( n = 6) and was associated with high BMI ( p = .038). The spinal cord ischemia rate was 21% ( n = 15) and was associated with type II aneurysms (OR 5.4, 95% CI 1.1-26.7, p = .04), smoking (OR 6.0, 95% CI 1.3-27.6, p = .02) and intraoperative blood loss (OR 1.1, 95% CI 1.0-1.3, p = .01). Survival at one, two and three years was 84 ± 4%, 70 ± 6% and 67 ± 6%, respectively. Freedom from aortic-related reinterventions at one, two and three years was 80 ± 5%, 65 ± 7% and 50 ± 8%, respectively; Conclusion : The study showed low early mortality (9%) and satisfactory mid-term survival. Technical success was achieved in acceptable 87% of procedures. The rate of spinal cord ischemia was high, occurring in 21% of patients. |
