Endovascular Repair of Ascending Aortic Pathologies With Tubular Endografts: A Single-Center Experience
Standard
Endovascular Repair of Ascending Aortic Pathologies With Tubular Endografts: A Single-Center Experience. / Tsilimparis, Nikolaos; Drewitz, Stefan; Detter, Christian; Spanos, Konstantinos; von Kodolitsch, Yskert; Rohlffs, Fiona; Reichenspurner, Herrmann; Debus, E Sebastian; Kölbel, Tilo.
in: J ENDOVASC THER, Jahrgang 26, Nr. 4, 08.2019, S. 439-445.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
Harvard
APA
Vancouver
Bibtex
}
RIS
TY - JOUR
T1 - Endovascular Repair of Ascending Aortic Pathologies With Tubular Endografts: A Single-Center Experience
AU - Tsilimparis, Nikolaos
AU - Drewitz, Stefan
AU - Detter, Christian
AU - Spanos, Konstantinos
AU - von Kodolitsch, Yskert
AU - Rohlffs, Fiona
AU - Reichenspurner, Herrmann
AU - Debus, E Sebastian
AU - Kölbel, Tilo
PY - 2019/8
Y1 - 2019/8
N2 - Purpose: To investigate the endovascular treatment of ascending aortic pathologies of high-risk patients unsuitable for open repair. Materials and Methods: From 2010 to 2017, 24 patients (mean age 70±15 years, range 29-90; 18 men) were treated at a single center for various pathologies of the ascending aorta, including acute or chronic type A aortic dissections (n=16), pseudoaneurysms (n=6), fixation of a dislocated percutaneous aortic valve (n=2), and miscellaneous indications (n=3). The patients were selected following an interdisciplinary case evaluation, attended by cardiologists and cardiac and vascular surgeons. The Zenith Ascend TAA Endovascular Graft was implanted; simultaneous procedures were performed in 13 patients. Of the total 27 Ascend TEVAR procedures (24 primary and 3 reinterventions), 17 were performed urgently and 10 electively. The primary outcome measure was 30-day survival. The secondary outcomes were cardiovascular complications, midterm survival, and reintervention rate. Results: Clinical success was achieved in all but 1 case. The 30-day survival was 79% (19/24); of the 5 deaths only 1 was directly related to the endograft implanted. In the 30-day postoperative period, there was 1 myocardial infarction, 2 major strokes, a mycotic pseudoaneurysm, a case of Ascend TEVAR-induced high-grade aortic insufficiency, and a minor stroke; 1 patient developed paraplegia after concurrent implantation of a 4-branched abdominal stent-graft. Two patients had a reintervention within 30 days for the pseudoaneurysm and the aortic insufficiency, respectively. During a mean follow-up of 11 months (0-35 months), there was 1 late death (cancer) and 1 additional reintervention at 10 months for a late type Ia endoleak (12.5% reintervention rate). Conclusion: Endovascular repair of ascending aortic pathologies with stent-grafts is a feasible treatment option with acceptable early and midterm outcomes in high-risk patients unsuitable for open surgery. The complexity of Ascend TEVAR might justify higher reintervention rates.
AB - Purpose: To investigate the endovascular treatment of ascending aortic pathologies of high-risk patients unsuitable for open repair. Materials and Methods: From 2010 to 2017, 24 patients (mean age 70±15 years, range 29-90; 18 men) were treated at a single center for various pathologies of the ascending aorta, including acute or chronic type A aortic dissections (n=16), pseudoaneurysms (n=6), fixation of a dislocated percutaneous aortic valve (n=2), and miscellaneous indications (n=3). The patients were selected following an interdisciplinary case evaluation, attended by cardiologists and cardiac and vascular surgeons. The Zenith Ascend TAA Endovascular Graft was implanted; simultaneous procedures were performed in 13 patients. Of the total 27 Ascend TEVAR procedures (24 primary and 3 reinterventions), 17 were performed urgently and 10 electively. The primary outcome measure was 30-day survival. The secondary outcomes were cardiovascular complications, midterm survival, and reintervention rate. Results: Clinical success was achieved in all but 1 case. The 30-day survival was 79% (19/24); of the 5 deaths only 1 was directly related to the endograft implanted. In the 30-day postoperative period, there was 1 myocardial infarction, 2 major strokes, a mycotic pseudoaneurysm, a case of Ascend TEVAR-induced high-grade aortic insufficiency, and a minor stroke; 1 patient developed paraplegia after concurrent implantation of a 4-branched abdominal stent-graft. Two patients had a reintervention within 30 days for the pseudoaneurysm and the aortic insufficiency, respectively. During a mean follow-up of 11 months (0-35 months), there was 1 late death (cancer) and 1 additional reintervention at 10 months for a late type Ia endoleak (12.5% reintervention rate). Conclusion: Endovascular repair of ascending aortic pathologies with stent-grafts is a feasible treatment option with acceptable early and midterm outcomes in high-risk patients unsuitable for open surgery. The complexity of Ascend TEVAR might justify higher reintervention rates.
KW - Adult
KW - Aged
KW - Aged, 80 and over
KW - Aorta, Thoracic/diagnostic imaging
KW - Aortic Diseases/diagnostic imaging
KW - Blood Vessel Prosthesis
KW - Blood Vessel Prosthesis Implantation/adverse effects
KW - Endovascular Procedures/adverse effects
KW - Female
KW - Humans
KW - Male
KW - Middle Aged
KW - Postoperative Complications/mortality
KW - Prosthesis Design
KW - Reoperation
KW - Retrospective Studies
KW - Risk Factors
KW - Stents
KW - Time Factors
KW - Treatment Outcome
U2 - 10.1177/1526602819852083
DO - 10.1177/1526602819852083
M3 - SCORING: Journal article
C2 - 31140362
VL - 26
SP - 439
EP - 445
JO - J ENDOVASC THER
JF - J ENDOVASC THER
SN - 1526-6028
IS - 4
ER -