Editor's Choice - Subsequent Results for Arch Aneurysm Repair with Inner Branched Endografts
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Editor's Choice - Subsequent Results for Arch Aneurysm Repair with Inner Branched Endografts. / Spear, R; Haulon, S; Ohki, T; Tsilimparis, N; Kanaoka, Y; Milne, C P E; Debus, S; Takizawa, R; Kölbel, T.
In: EUR J VASC ENDOVASC, Vol. 51, No. 3, 03.2016, p. 380-385.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Editor's Choice - Subsequent Results for Arch Aneurysm Repair with Inner Branched Endografts
AU - Spear, R
AU - Haulon, S
AU - Ohki, T
AU - Tsilimparis, N
AU - Kanaoka, Y
AU - Milne, C P E
AU - Debus, S
AU - Takizawa, R
AU - Kölbel, T
N1 - Copyright © 2015 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.
PY - 2016/3
Y1 - 2016/3
N2 - OBJECTIVES: 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.METHODS: Included patients underwent repair of aortic arch aneurysms >55 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.RESULTS: 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.CONCLUSIONS: The early outcomes associated with this technology are favorable. Branched endografting of aortic arch aneurysms should be considered in patients unfit for open surgery.
AB - OBJECTIVES: 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.METHODS: Included patients underwent repair of aortic arch aneurysms >55 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.RESULTS: 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.CONCLUSIONS: The early outcomes associated with this technology are favorable. Branched endografting of aortic arch aneurysms should be considered in patients unfit for open surgery.
KW - Aged
KW - Aorta, Thoracic/surgery
KW - Aortic Aneurysm, Thoracic/surgery
KW - Blood Vessel Prosthesis
KW - Endovascular Procedures/methods
KW - Female
KW - Follow-Up Studies
KW - Humans
KW - Male
KW - Middle Aged
KW - Prosthesis Design
KW - Retrospective Studies
KW - Time Factors
KW - Treatment Outcome
KW - Vascular Grafting/methods
U2 - 10.1016/j.ejvs.2015.12.002
DO - 10.1016/j.ejvs.2015.12.002
M3 - SCORING: Journal article
C2 - 26818022
VL - 51
SP - 380
EP - 385
JO - EUR J VASC ENDOVASC
JF - EUR J VASC ENDOVASC
SN - 1078-5884
IS - 3
ER -
