Endoleaks Following Endovascular Repair of Thoracic Aortic Aneurysm: Etiology and Outcomes

Morales, Jose P.; Greenberg, Roy K.; Lu, Qingsheng; Cury, Marcelo; Hernandez, Adrián V.; Mohabbat, Walid; Moon, Michael; Morales, Catherine; Bathurst, Shona; Schoenhagen, Paul

doi:10.1583/08-2551.1

Cited by 79 publications

(63 citation statements)

References 24 publications

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“…Actually, cumulative rate of endoleak formation was comparable throughout the entire study period. Our rate of endoleak formation is acceptably low and well comparable with recent reports [18]. Improved understanding of factors associated with endoleak formation requiring treatment has contributed to these stable results.…”

Section: Discussionsupporting

confidence: 89%

The influence of gender on mortality in patients after thoracic endovascular aortic repair

Czerny

Hoebartner

Sodeck

et al. 2011

European Journal of Cardio-Thoracic Surgery

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Section: Discussionsupporting

confidence: 89%

The influence of gender on mortality in patients after thoracic endovascular aortic repair

Czerny

Hoebartner

Sodeck

et al. 2011

European Journal of Cardio-Thoracic Surgery

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“…Different predictors of endoleak have been analyzed in the literature, 5,6,8,9,[20][21][22] including male gender, larger aneurysm size, length of aorta covered by the stent graft, number of stents used, proximal landing zone, and aortic arch morphology. The predictive value of a number of these factors is still controversial, notably aorta length covered by stent graft, considered protective of proximal endoleak by Verhoye et al 9 and, on the contrary, predictive of endoleak by Parmer et al and Morales et al 21,22 In all these studies, results were based only on univariable analysis.…”

Section: Discussionmentioning

confidence: 99%

“…The predictive value of a number of these factors is still controversial, notably aorta length covered by stent graft, considered protective of proximal endoleak by Verhoye et al 9 and, on the contrary, predictive of endoleak by Parmer et al and Morales et al 21,22 In all these studies, results were based only on univariable analysis. In our experience, like that of Piffaretti et al, 5 both univariable and multivariable analyses were performed.…”

Section: Discussionmentioning

confidence: 99%

“…These findings have led some authors to modify their criteria of proximal aortic neck length in case of zone 1 endografting to 30 mm or more. 24,25 Furthermore, numerous studies 5,6,8,21 report landing zone 2 as anatomically unsuitable for stent graft implantation because it can favor endoleak. These authors argue, first, that LSA overstenting exposes the stent graft to abrupt angulation with, in consequence, excessive mechanical stress acting on the stent and incomplete apposition of the devices, thus incurring a risk of type I endoleak.…”

Section: Discussionmentioning

confidence: 99%

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Examination of factors in type I endoleak development after thoracic endovascular repair

Boufi

Aouini

Guivier-Curien

et al. 2015

Journal of Vascular Surgery

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“…6) However, endoleaks or stent graft migration remains an important problem. 8) We wrapped the proximal landing zone of the aorta with a graft strip to reduce the risk of late type I endoleak.…”

Section: Discussionmentioning

confidence: 99%

Aortic Arch Rerouting and OPCAB in a Patient With Situs Inversus Totalis

et al. 2014

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SummaryEndovascular therapy approaches for aortic aneurysm have lowered the mortality and morbidity rates even in highrisk patients; moreover, these approaches are applied in the management of aortic arch pathologies by transposition of the supra-aortic branches. We present the case of a 75-year-old female patient with situs inversus totalis on hemodialysis. The patient underwent off-pump aortic arch rerouting and thoracic endovascular aortic repair concomitant with coronary artery bypass grafting for distal aortic arch aneurysm and ischemic heart disease. (Int Heart J 2014; 55: 278-279) Key words: Endovascular therapy, Minimally invasive procedure A lthough hypothermic circulatory arrest with various forms of cerebral perfusion techniques has decreased the incidence of neurological complications in conventional aortic arch surgery, total arch replacement continues to be associated with significant mortality and morbidity in high-risk patients.1) Recent studies have demonstrated that less invasive approaches using thoracic endovascular aortic repair (TEVAR) of the aortic arch are feasible in patients who are considered to be at high risk for conventional surgical approaches. 2) Case ReportA frail, 75-year-old woman with situs inversus totalis undergoing hemodialysis due to diabetic nephropathy was referred to our institution for the management of a rapidly expanding distal aortic arch aneurysm, which was detected on chest radiography (Figure 1). In addition, she complained of mild chest discomfort during dialysis. Computed tomography (CT) confi rmed a saccular distal aortic arch aneurysm ( Figure 2A) and an incidentally detected left adrenal tumor, which was diagnosed as a pheochromocytoma by a series of serological examinations. Coronary angiography revealed 90% stenosis in the proximal portion of the interventricular branch of the left coronary artery, which is the counterpart of the left anterior descending artery. The patient had no pyrexia, and the infl ammatory parameters were within normal limits on hematological examination. She was also suffering from chronic sinusitis. Bilateral radial and brachial arteries had been used for multiple arteriovenous shunt operations for the preceding 18 years, but all of them had occluded subsequently, and a permanent blood access catheter inserted via the left internal jugular vein was used for hemodialysis.Considering her advanced age, comorbidities, and frailty, off-pump total arch rerouting and endovascular stent grafting with coronary artery bypass grafting were scheduled. We decided to use a saphenous vein to graft the coronary artery in order to shorten the operation time and minimize bleeding. During surgery, the ascending aorta was side-clamped with decreased pressure by snaring the inferior vena cava, a side-toside anastomosis was performed between a trifurcated graft (Hemashield; Maquet, Fairfi eld, NJ, USA) and the aorta, and subsequently, the brachiocephalic and carotid arteries were reconstructed in an end-to-end fashion. In-situ reconstruction of the s...

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Endoleaks Following Endovascular Repair of Thoracic Aortic Aneurysm: Etiology and Outcomes

Cited by 79 publications

References 24 publications

The influence of gender on mortality in patients after thoracic endovascular aortic repair

The influence of gender on mortality in patients after thoracic endovascular aortic repair

Examination of factors in type I endoleak development after thoracic endovascular repair

Aortic Arch Rerouting and OPCAB in a Patient With Situs Inversus Totalis

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