Endovascular treatment of complicated aortic aneurysms using a modified flow-diverting strategy: Mid- to long-term outcome from a multicenter cohort study
| Autor: | Yongxue, Zhang, Qingsheng, Lu, Simeng, Zhang, Zhihui, Liang, Jinguo, Cui, Zaiping, Jing |
|---|---|
| Rok vydání: | 2022 |
| Předmět: |
Male
Time Factors Aortic Aneurysm Thoracic Endovascular Procedures Thrombosis General Medicine Middle Aged Aortic Aneurysm Cohort Studies Blood Vessel Prosthesis Implantation Treatment Outcome Humans Female Stents Radiology Nuclear Medicine and imaging Prospective Studies Aged Aortic Aneurysm Abdominal |
| Zdroj: | The British Journal of Radiology. 95 |
| ISSN: | 1748-880X 0007-1285 |
| DOI: | 10.1259/bjr.20210859 |
| Popis: | Objectives: Frequently reported adverse events following flow-diverting stents’ treatment of aortic aneurysms indicate further refinements of this technique are required. This study aims at evaluating the clinical efficacy of an improved flow-diverting strategy. Methods: A modified flow-diverting procedure was utilized in selected patients, in which stent-grafts were used to cover the non-branched segment of the aneurysmal lesion while flow-diverting multilayered bare metal stents were applied to cover the reno-visceral segment. The safety and efficacy of this joint procedure were assessed by regular follow-up. Results: We screened 497 patients and included 67 cases (mean age: 67.07 ± 12.14 years; 53 males) between February 2012 and March 2018. The median number of stent-grafts and bare metal stents used in the procedure were 1 (range: 1 to 3) and 3 (range: 2 to 4), respectively. During a mean follow-up period of 34.54 ± 20.28 months, aneurysm maximum diameter decreased from 64.79 ± 10.31 to 59.32 ± 10.20 mm (p = 0.002), while sac thrombosis ratio increased from 26.01±10.99% to 98.46±4.84% (pConclusions: The joint procedure is characterized by significant aneurysm thrombosis along with high aneurysm stabilization/shrinkage and side-branches’ patency rate. It might represent a potential improvement of the flow-diverting strategy in treating complex aortic lesions, yet large-scale, prospective, and randomized trials are anticipated to draw a robust conclusion. Advances in knowledge: The joint procedure could potentially exclude complex aortic aneurysms from circulation while maintaining the collateral branches. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|