Total endovascular arch repair is the procedure of the future
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Total endovascular arch repair is the procedure of the future. / Spanos, Konstantinos; Tsilimparis, Nikolaos; Rohlffs, Fiona; Wipper, Sabine; Detter, Christian; Behrendt, Christian-Alexander; Debus, Sebastian E; Kölbel, Tilo.
In: J CARDIOVASC SURG, Vol. 59, No. 4, 08.2018, p. 559-571.Research output: SCORING: Contribution to journal › SCORING: Review article › Research
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TY - JOUR
T1 - Total endovascular arch repair is the procedure of the future
AU - Spanos, Konstantinos
AU - Tsilimparis, Nikolaos
AU - Rohlffs, Fiona
AU - Wipper, Sabine
AU - Detter, Christian
AU - Behrendt, Christian-Alexander
AU - Debus, Sebastian E
AU - Kölbel, Tilo
PY - 2018/8
Y1 - 2018/8
N2 - INTRODUCTION: This study evaluates the current experience on endovascular repair of the aortic arch pathologies, the feasibility and safety of the procedure.EVIDENCE ACQUISITION: A systematic review was performed. MEDLINE, CENTRAL, and Cochrane databases were searched with PRISMA methodology for published studies reporting on endovascular repair of aortic arch pathologies from 2000 to 2018.EVIDENCE SYNTHESIS: Thirteen non-randomized retrospective studies (either single or multicenter), two multicenter Registries and one multicenter non-randomized interventional study were included in the systematic review. The total number of patients who underwent total endovascular repair of the aortic arch pathology with either fenestrated, branched, or a combination of those devices or chimney technique was 952 patients (73%; 634/872 males, mean age ranging from 51 to 78 years). The technical success rate was 96.7% (921/952), while the 30-day mortality rate was 3.3% (32/952). The most common adverse events were endoleak type I (13.5%; 35/259), stroke (5.1%; 49/952), spinal cord ischemia (1.4%; 14/952) and retrograde dissection (1%; 8/952). During the follow-up period (mean ranging: 16.9 to 41.4 months; median ranging: 9 to 44.8 months) the total number of deaths was 31 (4.4%; 31/693). The total loss of supra-aortic vessel patency rate was 1.7% (14/803) and a re-intervention was needed in 50 patients (9%; 50/559; 11 open conversion).CONCLUSIONS: Endovascular repair of aortic arch pathologies is a feasible treatment option with good early and reasonable mid-term outcomes. This treatment modality approaches a level of maturity and may be considered as a solid alternative method of treatment.
AB - INTRODUCTION: This study evaluates the current experience on endovascular repair of the aortic arch pathologies, the feasibility and safety of the procedure.EVIDENCE ACQUISITION: A systematic review was performed. MEDLINE, CENTRAL, and Cochrane databases were searched with PRISMA methodology for published studies reporting on endovascular repair of aortic arch pathologies from 2000 to 2018.EVIDENCE SYNTHESIS: Thirteen non-randomized retrospective studies (either single or multicenter), two multicenter Registries and one multicenter non-randomized interventional study were included in the systematic review. The total number of patients who underwent total endovascular repair of the aortic arch pathology with either fenestrated, branched, or a combination of those devices or chimney technique was 952 patients (73%; 634/872 males, mean age ranging from 51 to 78 years). The technical success rate was 96.7% (921/952), while the 30-day mortality rate was 3.3% (32/952). The most common adverse events were endoleak type I (13.5%; 35/259), stroke (5.1%; 49/952), spinal cord ischemia (1.4%; 14/952) and retrograde dissection (1%; 8/952). During the follow-up period (mean ranging: 16.9 to 41.4 months; median ranging: 9 to 44.8 months) the total number of deaths was 31 (4.4%; 31/693). The total loss of supra-aortic vessel patency rate was 1.7% (14/803) and a re-intervention was needed in 50 patients (9%; 50/559; 11 open conversion).CONCLUSIONS: Endovascular repair of aortic arch pathologies is a feasible treatment option with good early and reasonable mid-term outcomes. This treatment modality approaches a level of maturity and may be considered as a solid alternative method of treatment.
KW - Aorta, Thoracic/surgery
KW - Aortic Aneurysm, Thoracic/surgery
KW - Blood Vessel Prosthesis
KW - Endovascular Procedures/methods
KW - Humans
KW - Prosthesis Design
KW - Stents
U2 - 10.23736/S0021-9509.18.10412-5
DO - 10.23736/S0021-9509.18.10412-5
M3 - SCORING: Review article
C2 - 29355297
VL - 59
SP - 559
EP - 571
JO - J CARDIOVASC SURG
JF - J CARDIOVASC SURG
SN - 0021-9509
IS - 4
ER -
