Physician-Modified Thoracic Stent-Grafts for the Treatment of Aortic Arch Lesions
| Autor: | Ludovic Canaud, Pierre Alric, Thomas Gandet, Kouhei Narayama, Tsuyoshi Shibata, Baris Ata Ozdemir, Kiyofumi Morishita, Toshio Baba |
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| Přispěvatelé: | Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Hakodate Municipal Hospital, Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Hakodate Municipal Hospital, Hakodate, Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS) |
| Rok vydání: | 2017 |
| Předmět: |
Male
Aortic arch Time Factors Computed Tomography Angiography aortic arch [SDV]Life Sciences [q-bio] medicine.medical_treatment Aorta Thoracic 030204 cardiovascular system & hematology fenestration 0302 clinical medicine Japan physician-modified stent-grafts 030212 general & internal medicine Aged 80 and over Endovascular Procedures endograft Middle Aged humanities 3. Good health surgeon-modified stent-graft scallop Treatment Outcome surgical procedures operative dissection cardiovascular system Female France Cardiology and Cardiovascular Medicine medicine.medical_specialty Aortic Diseases Dissection (medical) Prosthesis Design Aortography thoracic endovascular aortic repair Blood Vessel Prosthesis Implantation 03 medical and health sciences Aneurysm medicine.artery medicine Humans Radiology Nuclear Medicine and imaging cardiovascular diseases Aged Retrospective Studies business.industry Stent medicine.disease Blood Vessel Prosthesis Surgery aneurysm Feasibility Studies business Fenestration |
| Zdroj: | Journal of endovascular therapy Journal of endovascular therapy, International Society of Endovascular Specialists, 2017, 24 (4), pp.542--548. ⟨10.1177/1526602817714206⟩ |
| ISSN: | 1545-1550 1526-6028 |
| Popis: | International audience; To evaluate outcomes of physician-modified thoracic stent-grafts for the treatment of aortic arch aneurysms. METHODS: A retrospective dual-center analysis was performed involving 36 patients (mean age 74.7\textpm9 years, range 58-91; 27 men) with an aortic arch lesion who were treated between November 2013 and June 2016 using physician-modified thoracic stent-grafts. Half of the patients had a degenerative aneurysm; the remainder had type B dissection (n=9), traumatic transection (n=3), type Ia endoleak after previous endografting (n=5), or aortoesophageal fistula (n=1). All patients were considered to be at high surgical risk. Patients were treated using an aortic arch stent-graft with a single fenestration (n=24) or a proximal scallop (n=12); zone 0 was involved in 16 patients, zone 1 in 9, and zone 2 in 11. The modified thoracic stent-graft was deployed after supra-aortic branch revascularization in 24 (67%) patients. RESULTS: Mean time required for stent-graft modifications was 18 minutes (range 14-21). Technical success was obtained in all cases with no type I endoleak. One (3%) patient had a stroke without permanent sequelae. The 30-day mortality was 6%. During a mean follow-up of 11.4\textpm6 months (range 2-36), there were no conversions to open repair. The overall mortality was 14%; aorta-related mortality was 6%. CONCLUSION: Our experience suggests that physician-modified thoracic stent-grafts are feasible for aortic arch lesions and provide encouraging results in the short term. Durability concerns will need to be assessed. |
| Databáze: | OpenAIRE |
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