Endovascular Treatment of Post Type A Chronic Aortic Arch Dissection With a Branched Endograft
| العنوان: | Endovascular Treatment of Post Type A Chronic Aortic Arch Dissection With a Branched Endograft |
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| المؤلفون: | Stephen W.K. Cheng, Thomasz Jakimowicz, Dorian Verscheure, Matthew J. Eagleton, Anders Wanhainen, Tilo Kölbel, Donald Adam, Kevin Mani, Piotr M. Kasprzak, A.C. Watkins, Stéphan Haulon, Jonathan Sobocinski, Timothy Resch, Martin Claridge, Blandine Maurel, Nikolaos Tsilimparis, Dominique Fabre, Ferreira Marcelo, Geert Willem H. Schurink, Bijan Modarai, Said Abisi, Nuno Dias, Björn Sonesson |
| المساهمون: | MUMC+: MA Vaatchirurgie CVC (3), Vascular Surgery, RS: Carim - V03 Regenerative and reconstructive medicine vascular disease |
| المصدر: | Annals of Surgery, 273(5), 997-1003. LIPPINCOTT WILLIAMS & WILKINS |
| بيانات النشر: | Ovid Technologies (Wolters Kluwer Health), 2019. |
| سنة النشر: | 2019 |
| مصطلحات موضوعية: | Male, Aortic arch, Time Factors, Computed Tomography Angiography, aortic arch, Aorta, Thoracic, Global Health, Aortic aneurysm, 0302 clinical medicine, Risk Factors, Medicine, Hospital Mortality, Stroke, Aortic dissection, education.field_of_study, Endovascular Procedures, Middle Aged, EDITORS CHOICE, Treatment Outcome, dissection, SURGICAL-TREATMENT, 030220 oncology & carcinogenesis, endovascular, Female, 030211 gastroenterology & hepatology, RISK-FACTOR-ANALYSIS, STENT-GRAFT, medicine.medical_specialty, Population, Prosthesis Design, Blood Vessel Prosthesis Implantation, ANEURYSM, 03 medical and health sciences, Aneurysm, medicine.artery, Ascending aorta, Humans, education, Retrospective Studies, REPAIR, Aorta, Aortic Aneurysm, Thoracic, business.industry, medicine.disease, Surgery, FALSE LUMEN, Aortic Dissection, Chronic Disease, EXPERIENCE, business, REOPERATION, Follow-Up Studies |
| الوصف: | MINI: The objective of this study was to evaluate the outcome of endovascular repair of chronic aortic arch dissecting aneurysms with a custom-made branched endograft during follow-up after acute type A aortic dissection open repair. Unmatched outcomes are reported in a population at high risk for a redo sternotomy. 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. |
| تدمد: | 1528-1140 0003-4932 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::4dfa553a4c28c563753dd180a6a0ade0Test https://doi.org/10.1097/sla.0000000000003310Test |
| حقوق: | CLOSED |
| رقم الانضمام: | edsair.doi.dedup.....4dfa553a4c28c563753dd180a6a0ade0 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15281140 00034932 |
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