Editor's Choice – Subsequent Results for Arch Aneurysm Repair with Inner Branched Endografts
| Autor: | Sebastian Debus, C.P.E. Milne, Reo Takizawa, Stéphan Haulon, Yuji Kanaoka, Rafaelle Spear, Tilo Kölbel, Nikolaos Tsilimparis, Takao Ohki |
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| Rok vydání: | 2016 |
| Předmět: |
Male
Aortic arch medicine.medical_specialty Time Factors medicine.medical_treatment Aorta Thoracic 030204 cardiovascular system & hematology Prosthesis Design Revascularization 03 medical and health sciences 0302 clinical medicine medicine.artery Humans Medicine Fluoroscopy Arch aneurysm 030212 general & internal medicine Common carotid artery Aged Retrospective Studies Medicine(all) Aortic Aneurysm Thoracic medicine.diagnostic_test business.industry Open surgery Endovascular Procedures Aortic arch aneurysm Middle Aged Trunk Blood Vessel Prosthesis Surgery Treatment Outcome cardiovascular system Female Vascular Grafting Radiology Cardiology and Cardiovascular Medicine business Follow-Up Studies |
| Zdroj: | European Journal of Vascular and Endovascular Surgery. 51(3):380-385 |
| ISSN: | 1078-5884 |
| DOI: | 10.1016/j.ejvs.2015.12.002 |
| Popis: | The aim was to evaluate the current results of aortic arch aneurysm repair using inner branched endografts performed in three high volume aortic endovascular centers and to compare them to the pioneering global experience with this technology.Included patients underwent repair of aortic arch aneurysms55 mm in diameter using inner branched endograft technology between April 2013 and November 2014. All patients were deemed unfit for open surgery. Inner branches were designed to perfuse the brachiocephalic trunk and the left common carotid artery in all cases. A left subclavian artery (LSA) revascularization was performed prior to the arch endovascular repair. Data were collected retrospectively in an electronic database. Parameters included length of procedure, fluoroscopy time, contrast volume, technical success, presence of endoleaks, early and late complications, and mortality.Twenty-seven patients were included in the study. Technical success was achieved in all cases. No patients died during the 30 day post-operative period. Early neurologic events included two major strokes (7.4%) and one minor stroke (3.7%). Transient spinal cord ischemia with full recovery was observed in two patients (7.4%). Four patients (14.8%) underwent early (30 day) re-interventions; these were for an access complication, an ischemic limb and exploration of the left ventricle through a sternotomy in two patients. During follow up (median 12 months), one patient (3.7%) died from a remote thoraco-abdominal aneurysm rupture. There were three Type 2 endoleaks (11.1%). Two re-interventions (7.4%) were performed, one to treat a Type 2 endoleak and one to treat a septic false aneurysm. A significant decrease in overall mortality was observed when comparing patients from the early experience with patients from the current report.The early outcomes associated with this technology are favorable. Branched endografting of aortic arch aneurysms should be considered in patients unfit for open surgery. |
| Databáze: | OpenAIRE |
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