Endovascular Preservation of Segmental Arteries during Treatment of Thoracoabdominal Aortic Aneurysms with Fenestrated/Branched Stent Grafts: Feasibility and Outcomes
Standard
Endovascular Preservation of Segmental Arteries during Treatment of Thoracoabdominal Aortic Aneurysms with Fenestrated/Branched Stent Grafts: Feasibility and Outcomes. / Eleshra, Ahmed; Oderich, Gustavo S; McWilliams, Richard G; Panuccio, Giuseppe; Katsargyris, Athanasios; Tsilimparis, Nikolaos; Tenorio, Emanuel R; Fisher, Robert K; Verhoeven, Eric; Kölbel, Tilo.
In: J VASC INTERV RADIOL, Vol. 34, No. 7, 07.2023, p. 1149-1156.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
Harvard
APA
Vancouver
Bibtex
}
RIS
TY - JOUR
T1 - Endovascular Preservation of Segmental Arteries during Treatment of Thoracoabdominal Aortic Aneurysms with Fenestrated/Branched Stent Grafts: Feasibility and Outcomes
AU - Eleshra, Ahmed
AU - Oderich, Gustavo S
AU - McWilliams, Richard G
AU - Panuccio, Giuseppe
AU - Katsargyris, Athanasios
AU - Tsilimparis, Nikolaos
AU - Tenorio, Emanuel R
AU - Fisher, Robert K
AU - Verhoeven, Eric
AU - Kölbel, Tilo
N1 - Copyright © 2023 SIR. Published by Elsevier Inc. All rights reserved.
PY - 2023/7
Y1 - 2023/7
N2 - PURPOSE: To evaluate the technical success, feasibility, and outcomes of endovascular preservation of segmental arteries (SAs) during fenestrated/branched endovascular aortic repair (F/B-EVAR).MATERIALS AND METHODS: A multicenter, retrospective study was conducted in consecutive patients treated with F/B-EVAR and a branch or fenestration for SA preservation. Eleven patients (median age, 57 years; range, 45-73 years; 7 men) were included.RESULTS: Twelve SAs were preserved. Stent grafts were custom made with fenestrations, branches, or a combination of both in 1, 2, and 5 patients, respectively. A t-Branch stent graft was used in 2 patients, and a physician-modified thoracic stent graft with a branch was used in 1 patient. Eight branches and 4 fenestrations were used for the preservation of 12 SAs. Four fenestrations and 1 branch for the SAs were not bridged and were left for perfusion of the corresponding SAs. Technical success was achieved in 10 of 11 (91%) patients. No early mortality occurred. Early morbidities included renal insufficiency without dialysis in 1 patient and partially delayed paraplegia in 1 patient. Before discharge, computed tomography angiography (CTA) showed patency of all the SAs. The median follow-up duration was 30 months (range, 10-88 months). Late death occurred in 1 patient. Two SAs were occluded in 1 patient with 2 unstented fenestrations, as determined using 1-year follow-up CTA. This patient did not develop spinal cord ischemia (SCI). Other SAs remained patent during follow-up. One patient with a type IIIc endoleak was treated by relining of bridging stents.CONCLUSIONS: Endovascular preservation of SAs with F/B-EVAR for thoracoabdominal aortic aneurysm is feasible and safe in select patients and may add to preventive measures for SCI.
AB - PURPOSE: To evaluate the technical success, feasibility, and outcomes of endovascular preservation of segmental arteries (SAs) during fenestrated/branched endovascular aortic repair (F/B-EVAR).MATERIALS AND METHODS: A multicenter, retrospective study was conducted in consecutive patients treated with F/B-EVAR and a branch or fenestration for SA preservation. Eleven patients (median age, 57 years; range, 45-73 years; 7 men) were included.RESULTS: Twelve SAs were preserved. Stent grafts were custom made with fenestrations, branches, or a combination of both in 1, 2, and 5 patients, respectively. A t-Branch stent graft was used in 2 patients, and a physician-modified thoracic stent graft with a branch was used in 1 patient. Eight branches and 4 fenestrations were used for the preservation of 12 SAs. Four fenestrations and 1 branch for the SAs were not bridged and were left for perfusion of the corresponding SAs. Technical success was achieved in 10 of 11 (91%) patients. No early mortality occurred. Early morbidities included renal insufficiency without dialysis in 1 patient and partially delayed paraplegia in 1 patient. Before discharge, computed tomography angiography (CTA) showed patency of all the SAs. The median follow-up duration was 30 months (range, 10-88 months). Late death occurred in 1 patient. Two SAs were occluded in 1 patient with 2 unstented fenestrations, as determined using 1-year follow-up CTA. This patient did not develop spinal cord ischemia (SCI). Other SAs remained patent during follow-up. One patient with a type IIIc endoleak was treated by relining of bridging stents.CONCLUSIONS: Endovascular preservation of SAs with F/B-EVAR for thoracoabdominal aortic aneurysm is feasible and safe in select patients and may add to preventive measures for SCI.
KW - Male
KW - Humans
KW - Middle Aged
KW - Blood Vessel Prosthesis
KW - Aortic Aneurysm, Thoracoabdominal
KW - Blood Vessel Prosthesis Implantation/adverse effects
KW - Aortic Aneurysm, Thoracic/diagnostic imaging
KW - Retrospective Studies
KW - Feasibility Studies
KW - Treatment Outcome
KW - Risk Factors
KW - Prosthesis Design
KW - Stents
KW - Arteries
KW - Endovascular Procedures/adverse effects
U2 - 10.1016/j.jvir.2023.02.027
DO - 10.1016/j.jvir.2023.02.027
M3 - SCORING: Journal article
C2 - 36889436
VL - 34
SP - 1149
EP - 1156
JO - J VASC INTERV RADIOL
JF - J VASC INTERV RADIOL
SN - 1051-0443
IS - 7
ER -
