Global experience with an inner branched arch endograft
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Global experience with an inner branched arch endograft. / Haulon, Stéphan; Greenberg, Roy K; Spear, Rafaëlle; Eagleton, Matt; Abraham, Cherrie; Lioupis, Christos; Verhoeven, Eric; Ivancev, Krassi; Kölbel, Tilo; Stanley, Brendan; Resch, Timothy; Desgranges, Pascal; Maurel, Blandine; Roeder, Blayne; Chuter, Timothy; Mastracci, Tara.
In: J THORAC CARDIOV SUR, Vol. 148, No. 4, 10.2014, p. 1709-1716.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Global experience with an inner branched arch endograft
AU - Haulon, Stéphan
AU - Greenberg, Roy K
AU - Spear, Rafaëlle
AU - Eagleton, Matt
AU - Abraham, Cherrie
AU - Lioupis, Christos
AU - Verhoeven, Eric
AU - Ivancev, Krassi
AU - Kölbel, Tilo
AU - Stanley, Brendan
AU - Resch, Timothy
AU - Desgranges, Pascal
AU - Maurel, Blandine
AU - Roeder, Blayne
AU - Chuter, Timothy
AU - Mastracci, Tara
N1 - Copyright © 2014 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.
PY - 2014/10
Y1 - 2014/10
N2 - BACKGROUND: Branched endografts are a new option to treat arch aneurysm in high-risk patients.METHODS AND RESULTS: We performed a retrospective multicenter analysis of all patients with arch aneurysms treated with a new branched endograft designed with 2 inner branches to perfuse the supra aortic trunks. Thirty-eight patients were included. The median age was 71 years (range, 64-74 years). An American Society of Anesthesiologists score of 3 or 4 was reported in 89.5% (95% confidence interval [CI], 79.7-99.3) of patients. The 30-day mortality rate was 13.2% (95% CI, 2.2-24.2). Technical success was obtained in 32 patients (84.2% [95% CI, 72.4-95.9]). Early secondary procedures were performed in 4 patients (10.5% [95% CI, 0.7-20.3]). Early cerebrovascular complications were diagnosed in 6 patients (15.8% [95% CI, 4.0-27.6]), including 4 transient ischemic attacks, 1 stroke, and 1 subarachnoid hemorrhage. The median follow-up was 12 months (range, 6-12 months). During follow-up, no aneurysm-related death was detected. Secondary procedures during follow-up were performed in 3 patients (9.1% [95% CI, 0.0-19.1]), including 1 conversion to open surgery. We compared the first 10 patients (early experience group) with the subsequent 28 patients. Intraoperative complications and secondary procedures were significantly higher in the early experience group. Although not statistically significant, the early mortality was higher in the early experience group (30% [95% CI, 0.0-60.0]) versus the remainder (7.1% [95% CI, 0.0-16.9]; P=.066). Being part of the early experience group and ascending aortic diameter≥38 mm were found to be associated to higher rates of combined early mortality and neurologic complications.CONCLUSIONS: Our preliminary study confirms the feasibility and safety of the endovascular repair of arch aneurysms in selected patients who may not have other conventional options.CLINICAL TRIAL REGISTRATION INFORMATION: Thoracic IDE NCT00583817, FDA IDE# 000101.
AB - BACKGROUND: Branched endografts are a new option to treat arch aneurysm in high-risk patients.METHODS AND RESULTS: We performed a retrospective multicenter analysis of all patients with arch aneurysms treated with a new branched endograft designed with 2 inner branches to perfuse the supra aortic trunks. Thirty-eight patients were included. The median age was 71 years (range, 64-74 years). An American Society of Anesthesiologists score of 3 or 4 was reported in 89.5% (95% confidence interval [CI], 79.7-99.3) of patients. The 30-day mortality rate was 13.2% (95% CI, 2.2-24.2). Technical success was obtained in 32 patients (84.2% [95% CI, 72.4-95.9]). Early secondary procedures were performed in 4 patients (10.5% [95% CI, 0.7-20.3]). Early cerebrovascular complications were diagnosed in 6 patients (15.8% [95% CI, 4.0-27.6]), including 4 transient ischemic attacks, 1 stroke, and 1 subarachnoid hemorrhage. The median follow-up was 12 months (range, 6-12 months). During follow-up, no aneurysm-related death was detected. Secondary procedures during follow-up were performed in 3 patients (9.1% [95% CI, 0.0-19.1]), including 1 conversion to open surgery. We compared the first 10 patients (early experience group) with the subsequent 28 patients. Intraoperative complications and secondary procedures were significantly higher in the early experience group. Although not statistically significant, the early mortality was higher in the early experience group (30% [95% CI, 0.0-60.0]) versus the remainder (7.1% [95% CI, 0.0-16.9]; P=.066). Being part of the early experience group and ascending aortic diameter≥38 mm were found to be associated to higher rates of combined early mortality and neurologic complications.CONCLUSIONS: Our preliminary study confirms the feasibility and safety of the endovascular repair of arch aneurysms in selected patients who may not have other conventional options.CLINICAL TRIAL REGISTRATION INFORMATION: Thoracic IDE NCT00583817, FDA IDE# 000101.
KW - Aged
KW - Aortic Aneurysm, Thoracic/surgery
KW - Blood Vessel Prosthesis
KW - Blood Vessel Prosthesis Implantation/methods
KW - Feasibility Studies
KW - Female
KW - Humans
KW - Male
KW - Middle Aged
KW - Postoperative Complications/epidemiology
KW - Prosthesis Design
KW - Retrospective Studies
KW - Risk Factors
KW - Treatment Outcome
U2 - 10.1016/j.jtcvs.2014.02.072
DO - 10.1016/j.jtcvs.2014.02.072
M3 - SCORING: Journal article
C2 - 24685375
VL - 148
SP - 1709
EP - 1716
JO - J THORAC CARDIOV SUR
JF - J THORAC CARDIOV SUR
SN - 0022-5223
IS - 4
ER -
