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Comparison of singl...
Comparison of single- and multistage strategies during fenestrated-branched endovascular aortic repair of thoracoabdominal aortic aneurysms
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- Dias-Neto, Marina (author)
- Univ Texas Hlth Sci Ctr Houston, Houston, TX USA.,University of Texas Health Science Center at Houston
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- Tenorio, Emanuel R. (author)
- Univ Texas Hlth Sci Ctr Houston, Houston, TX USA.
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- Huang, Ying (author)
- Univ Texas Hlth Sci Ctr Houston, Houston, TX USA.
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show more...
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- Jakimowicz, Tomasz (author)
- Med Univ Warsaw, Warsaw, Poland.
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- Mendes, Bernardo C. (author)
- Mayo Clin, Div Vasc & Endovasc Surg, Rochester, MN USA.
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- Koelbel, Tilo (author)
- Univ Med Ctr Eppendorf UKE, Hamburg, Germany.
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- Sobocinski, Jonathan (author)
- Univ Lille, Aort Ctr, Vasc Surg, CHU Lille, Lille, France.;Univ Lille, INSERM, CHU Lille, Lille, France.
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- Bertoglio, Luca (author)
- Univ Vita Salute San Raffaele, San Raffaele Hosp, Milan, Italy.
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- Mees, Barend (author)
- Maastricht Univ, Med Ctr, Maastricht, Netherlands.
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- Gargiulo, Mauro (author)
- Univ Bologna, Univ Hosp Policlin S Orsola, Dept Vasc Surg, Bologna, Italy.
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- Dias, Nuno (author)
- 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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- Schanzer, Andres (author)
- Univ Massachusetts, Med Sch, Worcester, MA USA.
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- Gasper, Warren (author)
- Univ Calif San Francisco, San Francisco, CA USA.
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- Beck, Adam W. (author)
- Univ Alabama Birmingham, Birmingham, AL USA.
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- Farber, Mark A. (author)
- Univ N Carolina, Dept Surg, Div Vasc Surg, Chapel Hill, NC USA.
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- Mani, Kevin, 1975- (author)
- Uppsala universitet,Kärlkirurgi
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- Timaran, Carlos (author)
- Univ Texas Southwestern, Clin Heart & Vasc Ctr, Dallas, TX USA.
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- Schneider, Darren B. (author)
- Univ Penn, Perelman Sch Med, Div Vasc Surg & Endovasc Therapy, Philadelphia, PA USA.
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- Pedro, Luis Mendes (author)
- Hosp Santa Maria CHULN, Dept Vasc Surg, Lisbon, Portugal.;Univ Lisbon, Fac Med, Lisbon, Portugal.
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- Tsilimparis, Nikolaos (author)
- Ludwig Maximilians Univ Hosp, Dept Vasc Surg, Munich, Germany.
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- Haulon, Stephan (author)
- Univ Paris Saclay, Hop Marie Lannelongue, Grp Hosp Paris St Joseph, Aort Ctr, Paris, France.
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- Sweet, Matt (author)
- Univ Washington, Dept Surg, Div Vasc Surg, Seattle, WA USA.
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- Ferreira, Emilia (author)
- Ctr Hosp Univ Lisboa Cent, Dept Angiol & Vasc Surg, Hosp Santa Marta, Lisbon, Portugal.;Univ Nova Lisboa, NOVA Med Sch, Lisbon, Portugal.
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- Eagleton, Matthew (author)
- Massachusetts Gen Hosp, Div Vasc & Endovasc Surg, Boston, MA USA.
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- Yeung, Kak Khee (author)
- Vrije Univ Amsterdam Med Ctr, Amsterdam UMC, Amsterdam Cardiovasc Sci, Dept Vasc Surg, Amsterdam, Netherlands.
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- Khashram, Manar (author)
- Waikato Hosp, Dept Vasc Surg, Hamilton, New Zealand.;Univ Auckland, Dept Surg, Auckland, New Zealand.
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- Vacirca, Andrea (author)
- Univ Texas Hlth Sci Ctr Houston, Houston, TX USA.
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- Lima, Guilherme B. (author)
- Univ Texas Hlth Sci Ctr Houston, Houston, TX USA.
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- Baghbani-Oskouei, Aidin (author)
- Univ Texas Hlth Sci Ctr Houston, Houston, TX USA.
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- Jama, Katarzyna (author)
- Med Univ Warsaw, Warsaw, Poland.
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- Panuccio, Giuseppe (author)
- Univ Med Ctr Eppendorf UKE, Hamburg, Germany.
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- Rohlffs, Fiona (author)
- Univ Med Ctr Eppendorf UKE, Hamburg, Germany.
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- Chiesa, Roberto (author)
- Univ Vita Salute San Raffaele, San Raffaele Hosp, Milan, Italy.
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- Schurink, Geert Willem (author)
- Maastricht Univ, Med Ctr, Maastricht, Netherlands.
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- Lemmens, Charlotte (author)
- Maastricht Univ, Med Ctr, Maastricht, Netherlands.
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- Gallitto, Enrico (author)
- Univ Bologna, Univ Hosp Policlin S Orsola, Dept Vasc Surg, Bologna, Italy.
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- Faggioli, Gianluca (author)
- Univ Bologna, Univ Hosp Policlin S Orsola, Dept Vasc Surg, Bologna, Italy.
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- Karelis, Angelos (author)
- 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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- Parodi, Ezequiel (author)
- Univ N Carolina, Dept Surg, Div Vasc Surg, Chapel Hill, NC USA.
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- Gomes, Vivian (author)
- Univ N Carolina, Dept Surg, Div Vasc Surg, Chapel Hill, NC USA.
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- Wanhainen, Anders (author)
- Uppsala universitet,Kärlkirurgi
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- Dean, Anastasia (author)
- Uppsala universitet,Kärlkirurgi
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- Colon, Jesus Porras (author)
- Univ Texas Southwestern, Clin Heart & Vasc Ctr, Dallas, TX USA.
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- Pavarino, Felipe (author)
- Univ Texas Southwestern, Clin Heart & Vasc Ctr, Dallas, TX USA.
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- Melo, Ryan Gouveia e (author)
- Hosp Santa Maria CHULN, Dept Vasc Surg, Lisbon, Portugal.;Univ Lisbon, Fac Med, Lisbon, Portugal.;Ludwig Maximilians Univ Hosp, Dept Vasc Surg, Munich, Germany.
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- Crawford, Sean (author)
- Univ Paris Saclay, Hop Marie Lannelongue, Grp Hosp Paris St Joseph, Aort Ctr, Paris, France.
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- Garcia, Rita (author)
- Ctr Hosp Univ Lisboa Cent, Dept Angiol & Vasc Surg, Hosp Santa Marta, Lisbon, Portugal.;Univ Nova Lisboa, NOVA Med Sch, Lisbon, Portugal.
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- Ribeiro, Tiago (author)
- Ctr Hosp Univ Lisboa Cent, Dept Angiol & Vasc Surg, Hosp Santa Marta, Lisbon, Portugal.;Univ Nova Lisboa, NOVA Med Sch, Lisbon, Portugal.
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- Kappe, Kaj Olav (author)
- Vrije Univ Amsterdam Med Ctr, Amsterdam UMC, Amsterdam Cardiovasc Sci, Dept Vasc Surg, Amsterdam, Netherlands.
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- van Knippenberg, Samira Elize Mariko (author)
- Vrije Univ Amsterdam Med Ctr, Amsterdam UMC, Amsterdam Cardiovasc Sci, Dept Vasc Surg, Amsterdam, Netherlands.
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- Tran, Bich Lan (author)
- Vrije Univ Amsterdam Med Ctr, Amsterdam UMC, Amsterdam Cardiovasc Sci, Dept Vasc Surg, Amsterdam, Netherlands.
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- Gormley, Sinead (author)
- Waikato Hosp, Dept Vasc Surg, Hamilton, New Zealand.;Univ Auckland, Dept Surg, Auckland, New Zealand.
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- Oderich, Gustavo S. (author)
- Univ Texas Hlth Sci Ctr Houston, Houston, TX USA.,University of Texas Health Science Center at Houston
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Univ Texas Hlth Sci Ctr Houston, Houston, TX USA University of Texas Health Science Center at Houston (creator_code:org_t)
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- MOSBY-ELSEVIER, 2023
- 2023
- English.
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In: Journal of Vascular Surgery. - : MOSBY-ELSEVIER. - 0741-5214 .- 1097-6809. ; 77:6, s. 1588-1597
- Related links:
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http://dx.doi.org/10...
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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
Subject headings
Close
- Objective: The aim of this study was to compare outcomes of single or multistage approach during fenestrated-branched endovascular aortic repair (FB-EVAR) of extensive thoracoabdominal aortic aneurysms (TAAAs).Methods: We reviewed the clinical data of consecutive patients treated by FB-EVAR for extent I to III TAAAs in 24 centers (2006-2021). All patients received a single brand manufactured patient-specific or off-the-shelf fenestrated-branched stent grafts. Staging strategies included proximal thoracic aortic repair, minimally invasive segmental artery coil embolization, temporary aneurysm sac perfusion and combinations of these techniques. Endpoints were analyzed for elective repair in patients who had a single-or multistage approach before and after propensity score adjustment for baseline differences, including the composite 30-day/in-hospital mortality and/or permanent paraplegia, major adverse event, patient survival, and freedom from aortic-related mortality.Results: A total of 1947 patients (65% male; mean age, 71 +/- 8 years) underwent FB-EVAR of 155 extent I (10%), 729 extent II (46%), and 713 extent III TAAAs (44%). A single-stage approach was used in 939 patients (48%) and a multistage approach in 1008 patients (52%). A multistage approach was more frequently used in patients undergoing elective compared with non-elective repair (55% vs 35%; P < .001). Staging strategies were proximal thoracic aortic repair in 743 patients (74%), temporary aneurysm sac perfusion in 128 (13%), minimally invasive segmental artery coil embolization in 10 (1%), and combinations in 127 (12%). Among patients undergoing elective repair (n = 1597), the composite endpoint of 30-day/in-hospital mortality and/or permanent paraplegia rate occurred in 14% of single-stage and 6% of multistage approach patients (P < .001). After adjustment with a propensity score, multistage approach was associated with lower rates of 30-day/in-hospital mortality and/or permanent paraplegia (odds ratio, 0.466; 95% confidence interval, 0.271-0.801; P = .006) and higher patient survival at 1 year (86.9 +/- 1.3% vs 79.6 +/- 1.7%) and 3 years (72.7 +/- 2.1% vs 64.2 +/- 2.3%; adjusted hazard ratio, 0.714; 95% confidence interval, 0.528-0.966; P = .029), compared with a single stage approach.Conclusions: Staging elective FB-EVAR of extent I to III TAAAs was associated with decreased risk of mortality and/or permanent paraplegia at 30 days or within hospital stay, and with higher patient survival at 1 and 3 years.
Subject headings
- 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)
Keyword
- Fenestrated-branched endovascular aortic repair
- Multistage approach
- Single stage
- Spinal cord injury
- Thoracoabdominal aortic aneurysm
Publication and Content Type
- ref (subject category)
- art (subject category)
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Dias-Neto, Marin ...
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Tenorio, Emanuel ...
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Huang, Ying
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Jakimowicz, Toma ...
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Mendes, Bernardo ...
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Koelbel, Tilo
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Sobocinski, Jona ...
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Bertoglio, Luca
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Mees, Barend
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Gargiulo, Mauro
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Dias, Nuno
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Schanzer, Andres
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Gasper, Warren
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Beck, Adam W.
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Farber, Mark A.
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Mani, Kevin, 197 ...
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Timaran, Carlos
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Schneider, Darre ...
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Pedro, Luis Mend ...
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Tsilimparis, Nik ...
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Haulon, Stephan
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Sweet, Matt
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Ferreira, Emilia
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Eagleton, Matthe ...
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Yeung, Kak Khee
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Khashram, Manar
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Vacirca, Andrea
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Lima, Guilherme ...
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Baghbani-Oskouei ...
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Jama, Katarzyna
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Panuccio, Giusep ...
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Rohlffs, Fiona
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Chiesa, Roberto
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Schurink, Geert ...
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Lemmens, Charlot ...
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Gallitto, Enrico
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Faggioli, Gianlu ...
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Karelis, Angelos
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Parodi, Ezequiel
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Gomes, Vivian
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Wanhainen, Ander ...
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Dean, Anastasia
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Colon, Jesus Por ...
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Pavarino, Felipe
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Melo, Ryan Gouve ...
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Crawford, Sean
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Garcia, Rita
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Ribeiro, Tiago
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Kappe, Kaj Olav
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van Knippenberg, ...
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Tran, Bich Lan
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Gormley, Sinead
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Oderich, Gustavo ...
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Surgery
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Cardiac and Card ...
- Articles in the publication
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Journal of Vascu ...
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Uppsala University
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Lund University