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Multicenter trans-A...
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Abdelhalim, Mohamed A.British Heart Foundation
(författare)
Multicenter trans-Atlantic experience with fenestrated-branched endovascular aortic repair of chronic post-dissection thoracoabdominal aortic aneurysms
- Artikel/kapitelEngelska2023
Förlag, utgivningsår, omfång ...
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Elsevier,2023
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electronicrdacarrier
Nummerbeteckningar
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LIBRIS-ID:oai:DiVA.org:uu-514611
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https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-514611URI
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https://doi.org/10.1016/j.jvs.2023.05.053DOI
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https://lup.lub.lu.se/record/31fcc1f8-5f0b-4147-9738-6dafa35d8b65URI
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Språk:engelska
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Sammanfattning på:engelska
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Ämneskategori:ref swepub-contenttype
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Ämneskategori:art swepub-publicationtype
Anmärkningar
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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 och genrebeteckningar
Biuppslag (personer, institutioner, konferenser, titlar ...)
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Tenorio, Emanuel R.University of Texas
(författare)
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Oderich, Gustavo S.University of Texas
(författare)
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Haulon, StephanUniversity of Paris-Saclay
(författare)
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Warren, GasperUniversity of California, San Francisco
(författare)
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Adam, DonaldUniversity Hospitals Birmingham
(författare)
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Claridge, MartinUniversity Hospitals Birmingham
(författare)
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Butt, TalhaLund University,Lunds universitet,Vaskulära sjukdomar - kliniska studier,Forskargrupper vid Lunds universitet,Vascular Diseases - Clinical Research,Lund University Research Groups,Skåne University Hospital(Swepub:lu)med-tbt
(författare)
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Abisi, SaidGuy's and St Thomas' NHS Foundation Trust
(författare)
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Dias, Nuno V.Lund University,Lunds universitet,Vaskulära sjukdomar - kliniska studier,Forskargrupper vid Lunds universitet,Vascular Diseases - Clinical Research,Lund University Research Groups,Skåne University Hospital(Swepub:lu)ront-ndi
(författare)
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Kölbel, TiloUniversity Heart Center Hamburg(Swepub:lu)kirm-tko
(författare)
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Gallitto, EnricoSt. Orsola-Malpighi University Hospital
(författare)
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Gargiulo, MauroSt. Orsola-Malpighi University Hospital
(författare)
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Gkoutzios, PanosGuy's and St Thomas' NHS Foundation Trust
(författare)
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Panuccio, GiuseppeUniversity Heart Center Hamburg
(författare)
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Kuzniar, MarekUppsala University,Uppsala universitet,Kärlkirurgi(Swepub:uu)marku159
(författare)
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Mani, Kevin,1975-Uppsala University,Uppsala universitet,Kärlkirurgi(Swepub:uu)kevma940
(författare)
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Mees, Barend M.Yukioka Hospital
(författare)
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Schurink, Geert W.Yukioka Hospital
(författare)
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Sonesson, BjörnLund University,Lunds universitet,Vaskulära sjukdomar - kliniska studier,Forskargrupper vid Lunds universitet,Vascular Diseases - Clinical Research,Lund University Research Groups,Skåne University Hospital(Swepub:lu)kir-bso
(författare)
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Spath, PaoloSt. Orsola-Malpighi University Hospital
(författare)
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Wanhainen, AndersUppsala University,Uppsala universitet,Kärlkirurgi(Swepub:uu)anwan103
(författare)
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Schanzer, AndresUniversity of Massachusetts Medical School
(författare)
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Beck, Adam W.University of Alabama
(författare)
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Schneider, Darren B.University of Pennsylvania
(författare)
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Timaran, Carlos H.University of Texas Southwestern Medical Center
(författare)
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Eagleton, MatthewMassachusetts General Hospital
(författare)
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Farber, Mark A.University of North Carolina
(författare)
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Modarai, BijanBritish Heart Foundation
(författare)
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British Heart FoundationUniversity of Texas
(creator_code:org_t)
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Multicenter International Aortic Research Group
Sammanhörande titlar
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Ingår i:Journal of Vascular Surgery: Elsevier78:4, s. 854-862.e10741-52141097-6809
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Till lärosätets databas
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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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