Endograft Therapy for Diseases of the Descending Thoracic Aorta: Results in 43 High-Risk Patients

Lepore, Vincenzo; Lönn, Lars; Delle, Martin; Bugge, Mogens; Jeppsson, Anders; Kjellman, Ulf; Rådberg, Göran; Risberg, Bo

doi:10.1177/152660280200900617

Cited by 49 publications

(28 citation statements)

References 27 publications

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“…[40][41][42] In the TAAA endograft series that used SFD prophylactically, the O/E ratio was 0.54; 39-41 the mean O/E ratio for series reporting open TAAA repair using only SFD without hypothermia and neurochemical protection was approximately 0.55. In endograft series that used no protective adjuncts, the O/E ratio was 1.05.…”

Section: Discussionmentioning

confidence: 99%

“…In endograft series that used no protective adjuncts, the O/E ratio was 1.05. 35,36,[40][41][42] We recognize that most thoracic endovascular aortic repair (TEVAR) series have low-risk patients and those TEVAR series we included we modeled as thoracic aneurysms, which have a risk coefficient in the model of 0.01. The model assesses the risk of the population being studied whether it is high or low.…”

Section: Discussionmentioning

confidence: 99%

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A modern theory of paraplegia in the treatment of aneurysms of the thoracoabdominal aorta: An analysis of technique specific observed/expected ratios for paralysis

Acher

Wynn

2009

Journal of Vascular Surgery

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Paraplegia causation is anatomic but paraplegia prevention is physiologic (non-anatomic). We demonstrate that by using hypothermia, SFD, and increasing MAP, clinicians had similar improvements in paraplegia, reducing O/E deficit ratios from 1.03 to as low as 0.16, with or without intercostal reimplantation, and whether or not assisted circulation was used. Understanding the fundamental principles of paraplegia prevention and how to apply protective strategies leads to a reduction in paralysis in clinical series with or without the use of assisted circulation. This modern theory of paraplegia has significant implications for the rapidly advancing field of TAAA repair with branched endografts where the same principles apply.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A modern theory of paraplegia in the treatment of aneurysms of the thoracoabdominal aorta: An analysis of technique specific observed/expected ratios for paralysis

Acher

Wynn

2009

Journal of Vascular Surgery

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“…The percentages reported in the literature range from 0% to 44%. [14][15][16] In this study population, the rate of primary leaks was 23%. An inlet less than 2 cm from the left subclavian artery and located in the lesser curvature of the aortic arch is one of the factors predisposing to stent kinking and leaks during control angiography, as well as previous aortic surgical or endovascular manipulation.…”

Section: Discussionmentioning

confidence: 78%

Tratamento endovascular da dissecção crônica de aorta tipo B complicada

Metzger¹,

Fontes²,

Novero³

et al. 2012

Rev. Bras. Cardiol. Invasiva

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Background: Endovascular repair of aortic diseases is a well-established therapeutic alternative for patients with the appropriate anatomy and/or high surgical risk, as it provides lower morbidity and mortality rates. This study aimed to analyse the outcomes of asymptomatic patients undergoing endovascular treatment of thoracic aortic dissections with an aortic diameter > 5.5 cm or endoleaks. Technical success, therapeutic success, morbidity, mortality, and perioperative complication and reintervention rates were assessed. Methods: The present retrospective study, which was performed at a reference centre from January, 2010 to July, 2011, analysed consecutive patients undergoing endovascular repair of chronic complicated type B aortic dissections based on the Stanford classification. Results: Twenty-six patients were treated. The mean age was 56.4 ± 7 years, and 61.5% were males. Technical and therapeutic success rates were 100% and 74%, respectively. The perioperative mortality was 7.6%, and the mortality rate in the first year of follow-up was 19.3%. The reintervention rate was 15.3%. Conclusions: In the present study, endovascular treatment of chronic type B aortic dissections proved to be a feasible method associated with acceptable perioperative complication rates. The therapeutic success and reintervention rates indicated the

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“…The period of spontaneous resolution ranges from one week to eight months. In case of persistence of such leakage, corrective therapeutic interventions must be performed (11) . In the population with type I leakage, the authors found five patients in G1 and two in G2 with low-volume leakages at arteriography, which spontaneously resolved between the third and sixth months of follow-up.…”

Section: (7)mentioning

confidence: 99%

Tratamento endovascular das doenças da aorta torácica: análise dos resultados de um centro

Novero¹,

Metzger²,

Obregon³

et al. 2012

Radiol Bras

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Objective: To analyze treatment outcomes in a consecutive series of patients submitted to endovascular treatment of thoracic aortic disease. Technical success, therapeutic success, morbimortality, rate of perioperative complications and reinterventions were taken into consideration. Materials and Methods: The present retrospective study was developed in a reference center in the period from January 2010 to July 2011, involving patients submitted to endovascular treatment of thoracic aortic disease. The study population was divided into two groups: group 1 (G1) -true thoracic aortic aneurysms, aortic ulcer and pseudoaneurysm; group 2 (G2) -chronic type B aortic dissection. Results: Out of a total of 55 patients, 29 belonged to the G1 and 26 to the G2 group. Mean ages were 66.8 ± 10 and 56.4 ± 7 years, respectively. The technical and therapeutic success reached respectively 86.3% and 68.6% in G1 and 100% and 74% in G2. The perioperative mortality rate was 10.3% in G1 and 19.3% in G2. The reintervention rate was 10.3% in G1 and 15.3% in G2. Conclusion: In the present study, the endovascular treatment of thoracic aortic disease proved to be a feasible method associated with acceptable rate of complications. Keywords: Aneurysm; Vascular graft; Atherosclerosis.Objetivo: Analisar os resultados do tratamento de uma série consecutiva de pacientes submetidos a tratamento endovascular de doenças da aorta torácica. Foram observados o sucesso técnico, o sucesso terapêutico, a morbimortalidade e a taxa de complicações perioperatórias e de reintervenções. Materiais e Métodos: Estudo retrospectivo, realizado em um centro de referência, no período de janeiro de 2010 a julho de 2011, em que foram analisados pacientes submetidos a correção endovascular de doenças da aorta torácica. A população foi dividida em dois grupos: grupo 1 (G1) -aneurismas de aorta torácica verdadeiros, úlcera aórtica e pseudoaneurisma; grupo 2 (G2) -dissecção aórtica tipo B crônica. Resultados: Em um total de 55 pacientes tratados, 29 pertenciam ao G1 e 26, ao G2. As idades médias foram 66,8 ± 10 e 56,4 ± 7 anos, respectivamente. Os sucessos técnico e terapêutico foram, respectivamente, 86,3% e 68,6% no G1 e 100% e 74% no G2. A mortalidade perioperatória foi 10,3% no G1 e 7,6% no G2, com taxa de mortalidade anual de 10,3% no G1 e de 19,3% no G2. As taxas de reintervenções foram 10,3% e 15,3%, respectivamente. Conclusão: Em nosso estudo, o tratamento endovascular das doenças da aorta torácica demonstrou ser um método viável e associado a aceitáveis taxas de complicações. Unitermos: Aneurisma; Prótese vascular; Aterosclerose. . Aortic dissection is the most feared condition of the aorta and is twice as frequent as aortic rupture. The mortality rate associated with dissection ranges between 1% and 2% per hour, during the first 48 hours. Risk factors frequently associated with such condition include hypertension, cardiovascular and respiratory diseases. Dissection is three times more frequent in men than in women. The most common entry 7. PhD, Head

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Endograft Therapy for Diseases of the Descending Thoracic Aorta: Results in 43 High-Risk Patients

Abstract: Treatment of descending thoracic aortic diseases with an endovascular approach has acceptable early mortality and morbidity in high-risk patients. In selected cases, stent-grafts may afford the best therapy.

Cited by 49 publications

References 27 publications

A modern theory of paraplegia in the treatment of aneurysms of the thoracoabdominal aorta: An analysis of technique specific observed/expected ratios for paralysis

A modern theory of paraplegia in the treatment of aneurysms of the thoracoabdominal aorta: An analysis of technique specific observed/expected ratios for paralysis

Tratamento endovascular da dissecção crônica de aorta tipo B complicada

Tratamento endovascular das doenças da aorta torácica: análise dos resultados de um centro

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