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Multicenter trans-A...
Multicenter trans-Atlantic experience with fenestrated-branched endovascular aortic repair of chronic post-dissection thoracoabdominal aortic aneurysms
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- Abdelhalim, Mohamed A. (författare)
- British Heart Foundation
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- Tenorio, Emanuel R. (författare)
- University of Texas
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- Oderich, Gustavo S. (författare)
- University of Texas
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visa fler...
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- Haulon, Stephan (författare)
- University of Paris-Saclay
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- Warren, Gasper (författare)
- University of California, San Francisco
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- Adam, Donald (författare)
- University Hospitals Birmingham
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- Claridge, Martin (författare)
- University Hospitals Birmingham
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- Butt, Talha (författare)
- Lund University,Lunds universitet,Vaskulära sjukdomar - kliniska studier,Forskargrupper vid Lunds universitet,Vascular Diseases - Clinical Research,Lund University Research Groups,Skåne University Hospital
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- Abisi, Said (författare)
- Guy's and St Thomas' NHS Foundation Trust
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- Dias, Nuno V. (författare)
- Lund University,Lunds universitet,Vaskulära sjukdomar - kliniska studier,Forskargrupper vid Lunds universitet,Vascular Diseases - Clinical Research,Lund University Research Groups,Skåne University Hospital
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- Kölbel, Tilo (författare)
- University Heart Center Hamburg
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- Gallitto, Enrico (författare)
- St. Orsola-Malpighi University Hospital
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- Gargiulo, Mauro (författare)
- St. Orsola-Malpighi University Hospital
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- Gkoutzios, Panos (författare)
- Guy's and St Thomas' NHS Foundation Trust
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- Panuccio, Giuseppe (författare)
- University Heart Center Hamburg
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- Kuzniar, Marek (författare)
- Uppsala University,Uppsala universitet,Kärlkirurgi
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- Mani, Kevin, 1975- (författare)
- Uppsala University,Uppsala universitet,Kärlkirurgi
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- Mees, Barend M. (författare)
- Yukioka Hospital
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- Schurink, Geert W. (författare)
- Yukioka Hospital
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- Sonesson, Björn (författare)
- Lund University,Lunds universitet,Vaskulära sjukdomar - kliniska studier,Forskargrupper vid Lunds universitet,Vascular Diseases - Clinical Research,Lund University Research Groups,Skåne University Hospital
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- Spath, Paolo (författare)
- St. Orsola-Malpighi University Hospital
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- Wanhainen, Anders (författare)
- Uppsala University,Uppsala universitet,Kärlkirurgi
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- Schanzer, Andres (författare)
- University of Massachusetts Medical School
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- Beck, Adam W. (författare)
- University of Alabama
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- Schneider, Darren B. (författare)
- University of Pennsylvania
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- Timaran, Carlos H. (författare)
- University of Texas Southwestern Medical Center
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- Eagleton, Matthew (författare)
- Massachusetts General Hospital
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- Farber, Mark A. (författare)
- University of North Carolina
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- Modarai, Bijan (författare)
- British Heart Foundation
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(creator_code:org_t)
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- Elsevier, 2023
- 2023
- Engelska.
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Ingår i: Journal of Vascular Surgery. - : Elsevier. - 0741-5214 .- 1097-6809. ; 78:4, s. 854-862.e1
- Relaterad länk:
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https://doi.org/10.1...
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https://uu.diva-port... (primary) (Raw object)
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http://dx.doi.org/10... (free)
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https://urn.kb.se/re...
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https://doi.org/10.1...
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https://lup.lub.lu.s...
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Abstract
Ämnesord
Stäng
- OBJECTIVE: This multicenter international study aimed to describe outcomes of fenestrated-branched endovascular aortic repairs (FB-EVAR) in a cohort of patients treated for chronic post-dissection thoracoabdominal aortic aneurysms (PD-TAAAs).METHODS: We reviewed the clinical data of all consecutive patients treated by FB-EVAR for repair of extent I to III PD-TAAAs in 16 centers from the United States and Europe (2008-2021). Data were extracted from institutional prospectively maintained databases and electronic patient records. All patients received off-the-shelf or patient-specific manufactured fenestrated-branched stent grafts. Endpoints were any cause mortality and major adverse events at 30 days, technical success, target artery (TA) patency, freedom from TA instability, minor (endovascular with <12 Fr sheath) and major (open or ≥12 Fr sheath) secondary interventions, patient survival, and freedom from aortic-related mortality (ARM).RESULTS: A total of 246 patients (76% male; median age, 67 years [interquartile range, 61-73 years]) were treated for extent I (7%), extent II (55%), and extent III (35%) PD-TAAAs by FB-EVAR. The median aneurysm diameter was 65 mm (interquartile range, 59-73 mm). Eighteen patients (7%) were octogenarians, 212 (86%) were American Society of Anesthesiologists class ≥3, and 21 (9%) presented with contained ruptured or symptomatic aneurysms. There were 917 renal-mesenteric vessels targeted by 581 fenestrations (63%) and 336 directional branches (37%), with a mean of 3.7 vessels per patient. Technical success was 96%. Mortality and rate of major adverse events at 30 days was 3% and 28%, including disabling complications such as new onset dialysis in 1%, major stroke in 1%, and permanent paraplegia in 2%. Mean follow-up was 24 months. Kaplan-Meier (KM) estimated patient survival at 3 and 5 years was 79% ± 6% and 65% ± 10%. KM estimated freedom from ARM was 95% ± 3% and 93% ± 5% at the same intervals. Unplanned secondary interventions were needed in 94 patients (38%), including minor procedures in 64 (25%) and major procedures in 30 (12%). There was one conversion to open surgical repair (<1%). KM estimated freedom from any secondary intervention was 44% ± 9% at 5 years. KM estimated primary and secondary TA patency were 93% ± 2% and 96% ± 1% at 5 years, respectively.CONCLUSIONS: FB-EVAR for chronic PD-TAAAs was associated with high technical success and a low rate of mortality (3%) and disabling complications at 30 days. Although the procedure is effective in the prevention of ARM, patient survival was low at 5 years (65%), likely due to the significant comorbidities in this cohort of patients. Freedom from secondary interventions at 5 years was 44%, although most procedures were minor. The significant rate of reinterventions highlights the need for continued patient surveillance.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)
Nyckelord
- Aortic dissection
- BEVAR
- Branched
- FEVAR
- Fenestrated
- Thoracoabdominal aortic aneurysm
- Aortic dissection
- BEVAR
- Branched
- Fenestrated
- FEVAR
- Thoracoabdominal aortic aneurysm
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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Till lärosätets databas
- Av författaren/redakt...
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Abdelhalim, Moha ...
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Tenorio, Emanuel ...
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Oderich, Gustavo ...
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Haulon, Stephan
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Warren, Gasper
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Adam, Donald
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visa fler...
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Claridge, Martin
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Butt, Talha
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Abisi, Said
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Dias, Nuno V.
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Kölbel, Tilo
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Gallitto, Enrico
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Gargiulo, Mauro
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Gkoutzios, Panos
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Panuccio, Giusep ...
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Kuzniar, Marek
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Mani, Kevin, 197 ...
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Mees, Barend M.
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Schurink, Geert ...
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Sonesson, Björn
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Spath, Paolo
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Wanhainen, Ander ...
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Schanzer, Andres
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Beck, Adam W.
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Schneider, Darre ...
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Timaran, Carlos ...
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Eagleton, Matthe ...
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Farber, Mark A.
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Modarai, Bijan
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visa färre...
- Om ämnet
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Klinisk medicin
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och Kardiologi
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Klinisk medicin
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och Kirurgi
- Artiklar i publikationen
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Journal of Vascu ...
- Av lärosätet
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Uppsala universitet
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Lunds universitet