International experience with endovascular therapy of the ascending aorta with a dedicated endograft
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International experience with endovascular therapy of the ascending aorta with a dedicated endograft. / Tsilimparis, Nikolaos; Debus, E Sebastian; Oderich, Gustavo S; Haulon, Stephan; Terp, Kim Allan; Roeder, Blayne; Detter, Christian; Kölbel, Tilo.
In: J VASC SURG, Vol. 63, No. 6, 06.2016, p. 1476-1482.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - International experience with endovascular therapy of the ascending aorta with a dedicated endograft
AU - Tsilimparis, Nikolaos
AU - Debus, E Sebastian
AU - Oderich, Gustavo S
AU - Haulon, Stephan
AU - Terp, Kim Allan
AU - Roeder, Blayne
AU - Detter, Christian
AU - Kölbel, Tilo
N1 - Copyright © 2016 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.
PY - 2016/6
Y1 - 2016/6
N2 - OBJECTIVE: The objective of this study was to evaluate the safety and feasibility of a novel stent graft specifically designed for treatment of the ascending aorta.METHODS: This was a multicenter, retrospective analysis of all consecutive patients treated with the dedicated Zenith Ascend TAA Endovascular Graft (William Cook Europe, Bjaeverskov, Denmark) for pathologic processes requiring stent grafting of the ascending aorta. The graft is short (6.5 cm), with a delivery system designed for transfemoral placement in the ascending aorta.RESULTS: In 10 patients (five men; age, 67 years; range, 26-90 years), the Zenith Ascend graft was implanted for the following indications: dissection (n = 5) and aneurysm (n = 4) of the ascending aorta and fixation of an intraprocedural dislocated aortic valve (n = 1). All patients were judged to be at high risk for open surgery (nine patients were classified as American Society of Anesthesiologists class 3 or class 4). A transfemoral approach was selected in eight cases and a transapical approach in two. All endografts were successfully deployed without intraoperative adverse events at the targeted landing zone. Clinical success in coverage of the lesions was achieved in all cases with the exception of an attempted treatment of an intraprocedural aortic valve implantation dissection that resulted in early mortality. The 30-day survival was 90%. Early neurologic events included one patient with stroke and paraplegia and one patient with a transient ischemic attack. One patient underwent early evacuation of a hemopericardium. There were two late reinterventions for persisting endoleaks. At a mean follow-up of 10 months (range, 1-36 months), three late deaths occurred, with one treatment related, as a result of graft infection.CONCLUSIONS: Despite the fact that in this first published series the graft was frequently used as a "rescue tool" outside its intended indication, treatment with the Zenith Ascend graft in this early experience appears to be safe and feasible for repair of ascending aorta pathologic processes in high-risk patients unsuitable for open repair.
AB - OBJECTIVE: The objective of this study was to evaluate the safety and feasibility of a novel stent graft specifically designed for treatment of the ascending aorta.METHODS: This was a multicenter, retrospective analysis of all consecutive patients treated with the dedicated Zenith Ascend TAA Endovascular Graft (William Cook Europe, Bjaeverskov, Denmark) for pathologic processes requiring stent grafting of the ascending aorta. The graft is short (6.5 cm), with a delivery system designed for transfemoral placement in the ascending aorta.RESULTS: In 10 patients (five men; age, 67 years; range, 26-90 years), the Zenith Ascend graft was implanted for the following indications: dissection (n = 5) and aneurysm (n = 4) of the ascending aorta and fixation of an intraprocedural dislocated aortic valve (n = 1). All patients were judged to be at high risk for open surgery (nine patients were classified as American Society of Anesthesiologists class 3 or class 4). A transfemoral approach was selected in eight cases and a transapical approach in two. All endografts were successfully deployed without intraoperative adverse events at the targeted landing zone. Clinical success in coverage of the lesions was achieved in all cases with the exception of an attempted treatment of an intraprocedural aortic valve implantation dissection that resulted in early mortality. The 30-day survival was 90%. Early neurologic events included one patient with stroke and paraplegia and one patient with a transient ischemic attack. One patient underwent early evacuation of a hemopericardium. There were two late reinterventions for persisting endoleaks. At a mean follow-up of 10 months (range, 1-36 months), three late deaths occurred, with one treatment related, as a result of graft infection.CONCLUSIONS: Despite the fact that in this first published series the graft was frequently used as a "rescue tool" outside its intended indication, treatment with the Zenith Ascend graft in this early experience appears to be safe and feasible for repair of ascending aorta pathologic processes in high-risk patients unsuitable for open repair.
KW - Adult
KW - Aged
KW - Aged, 80 and over
KW - Aorta/diagnostic imaging
KW - Aortic Diseases/diagnostic imaging
KW - Aortography/methods
KW - Blood Vessel Prosthesis
KW - Blood Vessel Prosthesis Implantation/adverse effects
KW - Computed Tomography Angiography
KW - Endovascular Procedures/adverse effects
KW - Feasibility Studies
KW - Female
KW - Humans
KW - Male
KW - Middle Aged
KW - Postoperative Complications/etiology
KW - Prosthesis Design
KW - Retreatment
KW - Retrospective Studies
KW - Risk Factors
KW - Stents
KW - Time Factors
KW - Treatment Outcome
U2 - 10.1016/j.jvs.2015.12.027
DO - 10.1016/j.jvs.2015.12.027
M3 - SCORING: Journal article
C2 - 26926935
VL - 63
SP - 1476
EP - 1482
JO - J VASC SURG
JF - J VASC SURG
SN - 0741-5214
IS - 6
ER -