Verscheure, Dorian and Haulon, Stephan and Tsilimparis, Nikolaos and Resch, Timothy and Wanhainen, Anders and Mani, Kevin and Dias, Nuno and Sobocinski, Jonathan and Eagleton, Matthew and Ferreira, Marcelo and Schurink, Geert Willem and Modarai, Bijan and Abisi, Said and Kasprzak, Piotr and Adam, Donald and Cheng, Stephen and Maurel, Blandine and Jakimowicz, Thomasz and Watkins, Amelia Claire and Sonesson, Bjorn and Claridge, Martin and Fabre, Dominique and Koelbel, Tilo (2021) Endovascular Treatment of Post Type A Chronic Aortic Arch Dissection With a Branched Endograft Early Results From a Retrospective International Multicenter Study. ANNALS OF SURGERY, 273 (5). pp. 997-1003. ISSN 0003-4932, 1528-1140
Full text not available from this repository. (Request a copy)Abstract
Objective: The objective of this study was to evaluate the outcome of endovascular aortic arch repair for chronic dissection with a custom-made branched endograft. Background: Acute type A aortic dissections are often treated with prosthetic replacement of the ascending aorta. During follow-up, repair of an aneurysmal evolution of the false lumen distal to the ascending prosthesis can be a challenge both for the surgeon and the patient. Methods: We conducted a multicenter, retrospective study of consecutive patients from 14 vascular units treated with a custom-made, inner-branched device (Cook Medical, Bloomington, IN) for chronic aortic arch dissection. Rates of in-hospital mortality and stroke, technical success, early and late complications, reinterventions, and mortality during follow-up were evaluated. Results: Seventy consecutive patients were treated between 2011 and 2018. All patients were considered unfit for conventional surgery. In-hospital combined mortality and stroke rate was 4% (n = 3), including 1 minor stroke, 1 major stroke causing death, and 1 death following multiorgan failure. Technical success rate was 94.3%. Twelve (17.1%) patients required early reinterventions: 8 for vascular access complication, 2 for endoleak correction, and 2 for pericardial effusion drainage. Median follow-up was 301 (138-642) days. During follow-up, 20 (29%) patients underwent secondary interventions: 9 endoleak corrections, 1 open repair for prosthetic kink, and 10 distal extensions of the graft to the thoracic or thoracoabdominal aorta. Eight patients (11%) died during follow-up because of nonaortic-related cause in 7 cases. Conclusions: Endovascular treatment of aortic arch chronic dissections with a branched endograft is associated with low mortality and stroke rates but has a high reintervention rate. Further follow-up is required to confirm the benefits of this novel approach.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | RISK-FACTOR-ANALYSIS; STENT-GRAFT; SURGICAL-TREATMENT; EDITORS CHOICE; FALSE LUMEN; REPAIR; SURGERY; ANEURYSM; EXPERIENCE; REOPERATION; aortic arch; dissection; endovascular |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Herz-, Thorax- und herznahe Gefäßchirurgie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 27 Sep 2022 08:50 |
| Last Modified: | 27 Sep 2022 08:50 |
| URI: | https://pred.uni-regensburg.de/id/eprint/48033 |
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