Anatomic Suitability for Branched Thoracic Endovascular Repair in Patients with Aortic Arch Pathological Features

Autor: Harmen R Zandbergen, Evert K. Jansen, M. Truijers, Willem Wisselink, Kak K. Yeung, Stefan P M Smorenburg, Theodorus G. van Schaik, Tijs J Hoogteijling, Matthew Montesano, Petr Symersky
Přispěvatelé: Surgery, Cardio-thoracic surgery, ACS - Microcirculation, ACS - Atherosclerosis & ischemic syndromes, ACS - Pulmonary hypertension & thrombosis
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Male
Aortic arch
anatomic suitability
medicine.medical_specialty
cardiothoracic surgery
Computed Tomography Angiography
aortic arch
medicine.medical_treatment
Aorta
Thoracic
thoracic endovascular repair
Prosthesis Design
vascular surgery
Postoperative Complications
Cardiovascular Disease
medicine.artery
Stent
medicine
Humans
In patient
Arch
Pathological
Original Research
Netherlands
Computed tomography angiography
Cardiovascular Surgery
Aortic Aneurysm
Thoracic
medicine.diagnostic_test
business.industry
Patient Selection
Endovascular Procedures
novel treatment
Middle Aged
Vascular surgery
Aneurysm
Blood Vessel Prosthesis
Aortic Dissection
Outcome and Process Assessment
Health Care
Cardiothoracic surgery
cardiovascular system
Female
Stents
Vascular Grafting
branched stent grafts
Radiology
Cardiology and Cardiovascular Medicine
business
Zdroj: Journal of the American Heart Association, 9(20):e016695. Wiley-Blackwell
Smorenburg, S P M, Montesano, M, Hoogteijling, T J, Truijers, M, Symersky, P, Jansen, E K, Zandbergen, H R, Wisselink, W, van Schaik, T G & Yeung, K K 2020, ' Anatomic Suitability for Branched Thoracic Endovascular Repair in Patients with Aortic Arch Pathological Features ', Journal of the American Heart Association, vol. 9, no. 20, e016695 . https://doi.org/10.1161/JAHA.120.016695
Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
ISSN: 2047-9980
Popis: Background Endovascular repair has become a viable alternative for aortic pathological features, including those located within the aortic arch. We investigated the anatomic suitability for branched thoracic endovascular repair in patients previously treated with conventional open surgery for aortic arch pathological features. Methods and Results Patients who underwent open surgery for aortic arch pathological features at our institution between 2000 and 2018 were included. Anatomic suitability was determined by strict compliance with the anatomic criteria within manufacturers’ instructions for use for each of the following branched thoracic stent grafts: Relay Plus Double‐Branched (Terumo‐Aortic), TAG Thoracic Branch Endoprosthesis (W.L. Gore & Associates), Zenith Arch Branched Device (Cook‐Medical), and Nexus Stent Graft System (Endospan Ltd/Jotec GmbH). Computed tomography angiography images were analyzed with outer luminal line measurements. A total of 377 patients (mean age, 64±14 years; 64% men) were identified, 153 of whom had suitable computed tomography angiography images for measurements. In total, 59 patients (15.6% of the total cohort and 38.6% of the measured cohort) were eligible for endovascular repair using at least one of the devices. Device suitability was 30.9% for thoracic aneurysms, 4.6% for type A dissections, 62.5% for type B dissections, and 28.6% for other pathological features. Conclusions The anatomic suitability for endovascular repair of all aortic arch pathological features was modest. The highest suitability rates were observed for thoracic aneurysms and for type B dissections, of which repair included part of the aortic arch. We suggest endovascular repair of arch pathological features should be reserved for high‐volume centers with experience in endovascular arch repair.
Databáze: OpenAIRE
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