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Sökning: WFRF:(Melissano Germano) > (2023) > Outcomes after endo...

Outcomes after endovascular aortic intervention in patients with connective tissue disease

Olsson, Karl Wilhelm, 1985- (författare)
Uppsala University,Uppsala universitet,Kärlkirurgi
Mani, Kevin, 1975- (författare)
Uppsala University,Uppsala universitet,Kärlkirurgi
Burdess, Anne (författare)
Uppsala University,Uppsala universitet,Kärlkirurgi
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Patterson, Suzannah (författare)
Division of Vascular Surgery and Endovascular Therapy, University of Florida, Gainesville, United States
Scali, Salvatore T. (författare)
Division of Vascular Surgery and Endovascular Therapy, University of Florida, Gainesville, United States
Kölbel, Tilo (författare)
Department of Vascular Medicine, German Aortic Center, University Heart Center, Hamburg, Germany
Panuccio, Giuseppe (författare)
Department of Vascular Medicine, German Aortic Center, University Heart Center, Hamburg, Germany
Eleshra, Ahmed (författare)
Department of Vascular Medicine, German Aortic Center, University Heart Center, Hamburg, Germany
Bertoglio, Luca (författare)
Division of Vascular Surgery, Vita Salute San Raffaele University, San Raffaele Hospital, Milano, Italy
Ardita, Vincenzo (författare)
Division of Vascular Surgery, Vita Salute San Raffaele University, San Raffaele Hospital, Milano, Italy
Melissano, Germano (författare)
Division of Vascular Surgery, Vita Salute San Raffaele University, San Raffaele Hospital, Milano, Italy
Acharya, Amish (författare)
Imperial Vascular Unit, Imperial College Healthcare NHS Trust, London, United Kingdom,Johns Hopkins Hospital
Bicknell, Colin (författare)
Imperial Vascular Unit, Imperial College Healthcare NHS Trust, London, United Kingdom
Riga, Celia (författare)
Imperial Vascular Unit, Imperial College Healthcare NHS Trust, London, United Kingdom
Gibbs, Richard (författare)
Imperial Vascular Unit, Imperial College Healthcare NHS Trust, London, United Kingdom
Jenkins, Michael (författare)
Imperial Vascular Unit, Imperial College Healthcare NHS Trust, London, United Kingdom
Bakthavatsalam, Arvind (författare)
Division of Vascular Surgery, Department of Surgery, University of Washington Medical Center, Seattle, United States
Sweet, Matthew P. (författare)
Division of Vascular Surgery, Department of Surgery, University of Washington Medical Center, Seattle, United States
Kasprzak, Piotr M. (författare)
Department of Vascular and Endovascular Surgery, University Medical Centre Regensburg, Regensburg, Germany,University Hospital Regensburg
Pfister, Karin (författare)
Department of Vascular and Endovascular Surgery, University Medical Centre Regensburg, Regensburg, Germany,University Hospital Regensburg
Oikonomou, Kyriakos (författare)
Department of Vascular and Endovascular Surgery, University Medical Centre Regensburg, Regensburg, Germany; Department of Vascular and Endovascular Surgery, Cardiovascular Surgery Clinic, University Hospital Frankfurt and Johann Wolfgang Goethe University Frankfurt, Frankfurt, Germany
Heloise, Tessely (författare)
Department of Vascular Surgery, Centre Hospitalier Universitaire de Lille, Lille, France,Lille University Hospital
Sobocinski, Jonathan (författare)
Department of Vascular Surgery, Centre Hospitalier Universitaire de Lille, Lille, France,Lille University Hospital
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
Dias, Nuno (författare)
Lund University,Lunds universitet,Vaskulära sjukdomar - kliniska studier,Forskargrupper vid Lunds universitet,Vascular Diseases - Clinical Research,Lund University Research Groups,Skåne University Hospital
Tang, Ching (författare)
Department of Surgery, Queen Mary Hospital, Hong Kong, China
Cheng, Stephen W. K. (författare)
Division of Vascular & Endovascular Surgery, Department of Surgery, University of Hong Kong Medical Centre, Hong Kong, China
Vandenhaute, Sarah (författare)
Department of Thoracic and Vascular Surgery, Ghent University Hospital, Ghent, Belgium
Van Herzeele, Isabelle (författare)
Department of Thoracic and Vascular Surgery, Ghent University Hospital, Ghent, Belgium
Sorber, Rebecca A. (författare)
Department of Vascular Surgery and Endovascular Therapy, Johns Hopkins Hospital, MD, Baltimore, Liberia
Black, James H. (författare)
Department of Vascular Surgery and Endovascular Therapy, Johns Hopkins Hospital, MD, Baltimore, Liberia
Tenorio, Emanuel R. (författare)
Department of Cardiothoracic & Vascular Surgery, Advanced Aortic Research Program at the University of Texas Health Science Center at Houston, McGovern Medical School, Houston, United States
Oderich, Gustavo S. (författare)
Department of Cardiothoracic & Vascular Surgery, Advanced Aortic Research Program at the University of Texas Health Science Center at Houston, McGovern Medical School, Houston, United States
Vincent, Zoë (författare)
Department of Vascular Surgery, Waikato Hospital, University of Auckland, Hamilton, New Zealand
Khashram, Manar (författare)
Department of Vascular Surgery, Waikato Hospital, University of Auckland, Hamilton, New Zealand
Eagleton, Matthew J. (författare)
Division of Vascular and Endovascular Surgery, Massachusetts General Hospital, MA, Boston, United States
Pedersen, Steen Fjord (författare)
Division of Vascular Surgery, Department of Cardiovascular Sugery, Aarhus University Hospital, Aarhus, Denmark
Budtz-Lilly, Jacob (författare)
Division of Vascular Surgery, Department of Cardiovascular Sugery, Aarhus University Hospital, Aarhus, Denmark
Lomazzi, Chiara (författare)
Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy,Maggiore Hospital Policlinico
Bissacco, Daniele (författare)
Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy,Maggiore Hospital Policlinico
Trimarchi, Santi (författare)
Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Clinical and Community Sciences, University of Milan, Milan, Italy,Maggiore Hospital Policlinico
Huerta, Abigail (författare)
Vascular Surgery Department, CardioVascular Institute, Hospital Clinic, Barcelona, Spain,Hospital Clínic of Barcelona
Riambau, Vincent (författare)
Vascular Surgery Department, CardioVascular Institute, Hospital Clinic, Barcelona, Spain,Hospital Clínic of Barcelona
Wanhainen, Anders (författare)
Uppsala University,Umeå University,Uppsala universitet,Umeå universitet,Kirurgi,Department of Surgical Sciences, Uppsala University, Uppsala, Sweden,Kärlkirurgi
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 (creator_code:org_t)
American Medical Association (AMA), 2023
2023
Engelska.
Ingår i: JAMA Surgery. - : American Medical Association (AMA). - 2168-6254 .- 2168-6262. ; 158:8, s. 832-839
Relaterad länk:
http://dx.doi.org/10...
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https://urn.kb.se/re...
https://doi.org/10.1...
https://urn.kb.se/re...
https://lup.lub.lu.s...
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  • Tidskriftsartikel (refereegranskat)
Abstract Ämnesord
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  • Importance: Endovascular treatment is not recommended for aortic pathologies in patients with connective tissue diseases (CTDs) other than in redo operations and as bridging procedures in emergencies. However, recent developments in endovascular technology may challenge this dogma.Objective: To assess the midterm outcomes of endovascular aortic repair in patients with CTD.Design, Setting, and Participants: For this descriptive retrospective study, data on demographics, interventions, and short-term and midterm outcomes were collected from 18 aortic centers in Europe, Asia, North America, and New Zealand. Patients with CTD who had undergone endovascular aortic repair from 2005 to 2020 were included. Data were analyzed from December 2021 to November 2022.Exposure: All principal endovascular aortic repairs, including redo surgery and complex repairs of the aortic arch and visceral aorta.Main Outcomes and Measures: Short-term and midterm survival, rates of secondary procedures, and conversion to open repair.Results: In total, 171 patients were included: 142 with Marfan syndrome, 17 with Loeys-Dietz syndrome, and 12 with vascular Ehlers-Danlos syndrome (vEDS). Median (IQR) age was 49.9 years (37.9-59.0), and 107 patients (62.6%) were male. One hundred fifty-two (88.9%) were treated for aortic dissections and 19 (11.1%) for degenerative aneurysms. One hundred thirty-six patients (79.5%) had undergone open aortic surgery before the index endovascular repair. In 74 patients (43.3%), arch and/or visceral branches were included in the repair. Primary technical success was achieved in 168 patients (98.2%), and 30-day mortality was 2.9% (5 patients). Survival at 1 and 5 years was 96.2% and 80.6% for Marfan syndrome, 93.8% and 85.2% for Loeys-Dietz syndrome, and 75.0% and 43.8% for vEDS, respectively. After a median (IQR) follow-up of 4.7 years (1.9-9.2), 91 patients (53.2%) had undergone secondary procedures, of which 14 (8.2%) were open conversions.Conclusions and Relevance: This study found that endovascular aortic interventions, including redo procedures and complex repairs of the aortic arch and visceral aorta, in patients with CTD had a high rate of early technical success, low perioperative mortality, and a midterm survival rate comparable with reports of open aortic surgery in patients with CTD. The rate of secondary procedures was high, but few patients required conversion to open repair. Improvements in devices and techniques, as well as ongoing follow-up, may result in endovascular treatment for patients with CTD being included in guideline recommendations.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kirurgi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Surgery (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kardiologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)

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