Endovascular repair of intercostal and visceral aortic patch aneurysms following open thoracoabdominal aortic aneurysm repair
| Autor: | Katarzyna Jama, F. Ezequiel Parodi, Giulianna B. Marcondes, Gustavo S. Oderich, Roberto Chiesa, Luca Bertoglio, Tomasz Jakimowicz, Bijan Modarai, Adam W. Beck, Mark A. Farber, Fernando Motta, Andres Schanzer, Emanuel R. Tenorio, Enrico Gallitto, Panos Gkoutzios, Mauro Gargiulo |
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| Přispěvatelé: | Tenorio, E. R., Oderich, G. S., Schanzer, A., Beck, A. W., Gargiulo, M., Farber, M. A., Modarai, B., Jakimowicz, T., Bertoglio, L., Chiesa, R., Gallitto, E., Marcondes, G. B., Parodi, F. E., Motta, F., Gkoutzios, P., Jama, K., Tenorio E.R., Oderich G.S., Schanzer A., Beck A.W., Gargiulo M., Farber M.A., Modarai B., Jakimowicz T., Bertoglio L., Chiesa R., Gallitto E., Marcondes G.B., Parodi F.E., Motta F., Gkoutzios P., Jama K. |
| Rok vydání: | 2020 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty fenestrated–branched endovascular aortic repair medicine.medical_treatment 030204 cardiovascular system & hematology open surgical repair Endovascular aneurysm repair 03 medical and health sciences 0302 clinical medicine Interquartile range medicine.artery medicine Superior mesenteric artery Adverse effect intercostal aortic patch aneurysm Surgical repair business.industry visceral aortic patch aneurysm Acute kidney injury medicine.disease Surgery medicine.anatomical_structure 030228 respiratory system Respiratory failure Cardiology and Cardiovascular Medicine business Artery |
| Zdroj: | The Journal of thoracic and cardiovascular surgery. |
| ISSN: | 1097-685X |
| Popis: | Purpose Reoperative open surgical repair (OSR) of thoracoabdominal aortic aneurysms (TAAAs) is associated with high morbidity and mortality. The aim of this study was to analyze outcomes of fenestrated–branched endovascular aneurysm repair (F-BEVAR) for the treatment of intercostal or visceral aortic patch aneurysms after OSR of TAAAs. Methods We reviewed the clinical data and outcomes of consecutive patients treated at 8 academic centers by F-BEVAR for visceral and intercostal aortic patch aneurysms after OSR of TAAAs (2011-2019). All patients had involvement of at least one target vessel requiring incorporation by a fenestration or directional branch. End points were technical success, 30-day and/in-hospital mortality, major adverse events, patient survival, target vessel patency/instability, and freedom from reintervention. Results There were 29 patients with a median age of 70 (interquartile range, 63-74) years. Seven patients (24%) had connective tissue disorders. Technical success was 100%. There were no 30-day/in-hospital mortalities. Major adverse events occurred in 5 patients (17%), including estimated blood loss >1 L in 3 patients (10%), acute kidney injury and respiratory failure in 2 patients (7%) each, and transient paraparesis in 1 patient (3%). Median follow-up was 14 (interquartile range, 7-37) months. At 2 years, primary and secondary patency, freedom from target artery instability, freedom from reintervention, and patient survival were 95%, 100%, 83%, 61%, and 96%, respectively. Conclusions F-BEVAR could be considered as an alternative to reoperative OSR in patients with visceral or intercostal aortic patch aneurysms. This series showed no mortality and a low rate of major adverse events, but a significant need for reintervention. |
| Databáze: | OpenAIRE |
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