Early and Long-term Results of Replacement of the Descending Aorta

Brandt, M.; Hussel, K; Walluscheck, Knut P.; Böning, Andreas; Rahimi, Aziz; Cremer, J.

doi:10.1016/j.ejvs.2005.04.005

Cited by 23 publications

(19 citation statements)

References 22 publications

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“…Despite advances in surgical techniques, perioperative anesthesiologic and postoperative reanimation care facilities, traditional surgical treatment of the pathology, ie, prosthetic graft replacement of the descending aorta, still carries considerable mortality (5%-20% in different series) [Estrera 2005] and morbidity rates (being of the most debilitating: paraplegia, visceral organ failure, prolonged mechanical ventilation) [Coselli 2004]. These high mortality and morbidity rates of surgical treatment of thoracic aortic aneurysms have always directed surgeons to search for alternative treatment modalities [Herold 2002;Umana 2002;Lamme 2003;Brandt 2005].…”

Section: Discussionmentioning

confidence: 99%

Endovascular Treatment of Thoracic Aortic Pathologies in Patients with Aortoiliac Occlusive Disease

Alpagut¹,

Uğurlucan²,

Dayıoğlu³

2007

The Heart Surgery Forum

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Today, with the increasing experience and advances in graft technology, endovascular grafting is applied nearly to all levels of the aorta for the treatment of various aortic pathologies. The major route of the stent graft deployment is from the femoral region through the iliac arteries. Since both aneurysms and arterial occlusive diseases share atherosclerosis as the common ancestor of etiology, some patients may poses both aneurysms and stenosis together. These stenotic changes occurring in the iliac and femoral arteries may complicate the passage of the stent graft system. In this report, we sought to evaluate an alternative novel route of graft system application for endovascular treatment of thoracic aortic aneurysms.

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Section: Discussionmentioning

confidence: 99%

Endovascular Treatment of Thoracic Aortic Pathologies in Patients with Aortoiliac Occlusive Disease

Alpagut¹,

Uğurlucan²,

Dayıoğlu³

2007

The Heart Surgery Forum

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“…A indicação dessa modalidade de tratamento tem limitações e está relacionada às condições anatômicas dos aneurismas 3,4 , mas vem se ampliando, progressivamente, em razão do aprimoramento e desenvolvimento das técnicas, dos materiais e equipamentos utilizados na realização desses procedimentos. As dificuldades para o emprego dessa técnica são maiores quando o aneurisma é extenso, envolvendo a aorta torácica e abdominal, com comprometimento das artérias viscerais e renais, e continuam sendo um grande desafio para o cirurgiões 5,6 . Convencionalmente, os AATA são tratados através de toracotomias, com amplas incisões no abdômen e no tórax 7 .…”

Section: Discussionunclassified

Tratamento do aneurisma da aorta toracoabdominal com endoprótese ramificada para as artérias viscerais

Simi

Ishii

Ferreira³

et al. 2007

J. vasc. bras.

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Apresentamos um caso de aneurisma da aorta toracoabdominal (AATA) tratado, exclusivamente, pela técnica endovascular, utilizando uma endoprótese ramificada e customizada. Paciente do sexo feminino, 68 anos de idade, tabagista, hipertensa, portadora de extenso AATA e múltiplas comorbidades que restringiam a indicação de cirurgia convencional. O aneurisma iniciava-se na aorta torácica descendente, estendendo-se até a aorta abdominal infra-renal, envolvendo as emergências das artérias viscerais, tronco celíaco, artérias mesentérica superior e renais. O AATA foi tratado pela técnica endovascular com implante de uma endoprótese ramificada. Essa endoprótese ramificada foi customizada com base nas características anatômicas da aorta e no posicionamento dos ramos viscerais, obtidos em angiotomografia, objetivando excluir o aneurisma, mantendo a perfusão das artérias viscerais. O procedimento foi realizado em centro cirúrgico, sob anestesia combinada, regional e geral, antecedido de drenagem liquórica e sob orientação fluoroscópica. O acesso para o implante do corpo principal da endoprótese ramificada e o controle radiológico foram realizados através das artérias femorais, previamente dissecadas. Através das ramificações da endoprótese, foram implantadas extensões secundárias, com stents revestidos, para as respectivas artérias viscerais, cujo acesso foi realizado via artéria axilar esquerda. O tempo total do procedimento foi de 14 horas, com 4 horas e 30 minutos de fluoroscopia, e foram utilizados 120 mL de contraste iodado. No pós-operatório, a paciente apresentou instabilidade hemodinâmica. Ecocardiograma transesofágico mostrou dissecção retrógrada da aorta torácica, tipo A, seguida de trombose espontânea da falsa luz. A tomografia de controle mostrou exclusão do AATA e perviedade das pontes para os ramos viscerais, sem vazamentos. A alta ocorreu no 13º dia de pós-operatório. O tratamento endovascular do AATA com endoprótese ramificada é factível. A melhora dos recursos técnicos e da qualidade dos materiais poderá ampliar a indicação desse procedimento como alternativa à cirurgia aberta.

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“…During in-hospital follow-up, renal failure after surgery and major postoperative neurological complications were recorded and at long term, follow-up free of Type I and III endoleaks [11] and follow-up free of reintervention due to progression and/or relapse [12].…”

Section: Methodsmentioning

confidence: 99%

Medium-Term Results of Treatment for Complicated Acute Type B Dissection: A Spanish Experience in a Single Centre

Álvarez‐García

Kiuri

Heredero

et al. 2014

Journal of Angiology

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Objective.To analyze and evaluate medium-term results obtained in endovascular treatment of complicated type B dissection.Methods.Prospective registry and retrospective analysis of the dissections treated with endoprosthesis in 1998 and 2010. Comorbidity, clinical presentation, anatomical characteristics, and evolution were recorded. Actuarial analysis was conducted for survival, follow-up and survival free of endoleaks, and free of reintervention due to relapse and/or progression.Results.Eighteen (18) patients were treated (14 male : 4 female), with a median age of 53 years (range 29–80). Their main symptoms were acute pain in 16 cases and hypertensive crisis in 15. The indications were 10 dissections not controlled by medication, 4 aneurysm dissecans, 2 acute lower limb ischemias, and 2 Type A progressions. Median 1.7 devices were used (range 1–4). Coverage of left subclavian artery was required in 3 cases, and of subclavian and left carotid artery in other 2 cases. There was a 100% technical success. Median follow-up was 43.1 months (1.5–127 range). There were two deaths caused by multiorganic failure, early mortality of 0%, and hospital mortality of 11%. There was a case of Type I Endoleak and 5 cases which required a new intervention due to relapse and/or progression. Cumulative survival at 30 months was 88%; follow-up free of endoleaks at 36 months was 91%. Follow-up free of progression/relapse at 12 months was 88%.Conclusion.Endovascular treatment of complicated type B acute dissection is an effective therapy for this condition, with a low associated mortality and with acceptable survival.

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Early and Long-term Results of Replacement of the Descending Aorta

Cited by 23 publications

References 22 publications

Endovascular Treatment of Thoracic Aortic Pathologies in Patients with Aortoiliac Occlusive Disease

Endovascular Treatment of Thoracic Aortic Pathologies in Patients with Aortoiliac Occlusive Disease

Tratamento do aneurisma da aorta toracoabdominal com endoprótese ramificada para as artérias viscerais

Medium-Term Results of Treatment for Complicated Acute Type B Dissection: A Spanish Experience in a Single Centre

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