Endoluminal stent grafting of the thoracic aorta: Initial experience with the Gore Excluder

Thompson, Charles S.; Gaxotte, Virginia; Rodríguez, J.A. Virseda; Ramaiah, Venkatesh G.; Vranic, Mitar; Ravi, Rajagopalan; DiMugno, Leanne; Shafique, Shoaib; Olsen, Dawn; Diethrich, Edward B.

doi:10.1067/mva.2002.122885

Cited by 81 publications

(55 citation statements)

References 28 publications

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“…Esta complicación ha sido reportada ocasionalmente en el manejo endovascular electivo de aneurismas de la aorta descendente, con mucha menor frecuencia que en la cirugía abierta 12,13 . Incluso en series recientes de reparación endovascular de lesiones aneurismáticas en general, no se reportan casos de paraplejia 16,[24][25][26] o incidencias inferiores a 2,5% 27,28 . En la presente serie, aunque pequeña, no tuvimos que lamentar esta devastadora complicación.…”

Section: Discussionunclassified

Tratamiento endovascular del trauma de aorta descendente

Sch

et al. 2005

Rev. méd. Chile

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Section: Discussionunclassified

Tratamiento endovascular del trauma de aorta descendente

Sch

et al. 2005

Rev. méd. Chile

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“…Bu takipte karşılaşılan stent-greft distorsiyonunu azaltır ve değişen anevrizma morfolojisini kompanse eder. [2] İnfra-renal yerleştirilen stent greftlerden farklı olarak torasik stent greftlerin üzerindeki siklik yük daha fazladır. Bunun nedeni, greftin kalbe yakın olması ve aortik kurvatur olabilir.…”

Section: Spi̇nal Kord İskemi̇si̇unclassified

“…Bu faktörleri içeren hasta nüfusu dışında cerrahi onarım açısından yüksek riskli her hasta endovasküler onarım için aday olabilir. [2] Endovasküler tedavi yöntemleri her zaman bir ekip çalışması gerektirir. Bu ekibin içinde kalp-damar cerrahı, radyoloji ve anestezi uzmanlarının uyumlu çalışması verimlilik açısından çok önemlidir.…”

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Endovascular treatment of thoracic aortic aneurysms

Posacıoğlu¹

2011

Turkish J Thorac Cardiovasc Surg Suppl2

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Distal aortun yaygın lezyonlarında konvansiyonel cerrahinin morbidite ve mortalite oranları göreceli olarak yüksek-tir. Stent greftler yaygın olarak distal torakal aort ve abdominal aortun hastalıkları için kullanılmaktadır. Bununla beraber, kaçak gelişmesi ve distal aorttan çıkan önemli dalların greftle kaplanması nedeniyle oluşabilen viseral ve spinal iskemi bu teknikle ilgili esas sorunlardır. Hastanın seyri çoğunlukla greftin proksimal kısmının uygun yerleş-tirilmesine bağlıdır. Anevrizmal aortun anatomik özellikle-ri stent greft komplikasyonlarının temel nedenidir.Anah tar söz cük ler: Aort anevrizması; endovasküler tamir; stent kayması.The morbidity and mortality rates of conventional surgery for the extensive distal aortic lesions are relatively high. Stent-grafting has been widely used for the diseases of the distal thoracic and abdominal aorta. However, endoleaks, and visceral and spinal cord ischemia due to coverage of critical branches of the distal aorta are major concerns related to this technique. The outcome mostly depends on the proper placement of the proximal part of the graft. Anatomical features of the aneurysmal aorta are the main cause of complications of the stent-grafts.

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“…10,27 The low operative mortality of 1% observed in this study, despite the patient population and the inclusion of open procedures, may be partly because approximately 70% of the patients underwent less invasive endovascular surgery; however, it is still lower than the reported operative mortality of 1.9-4.0% for endovascular surgery. 16,18,28 In the present study, perioperative risk stratification was undertaken using pharmacologic stress SPECT, which was performed safely in all patients. Although clinical features such as previous MI, DM and renal insufficiency are regarded as having a high predictive value for cardiac events, 10,27 the SPECT finding of a SSS ≥14 was the best predictor in the present study.…”

Section: Discussionmentioning

confidence: 99%

“…The indication for aortic surgery was decided by cardiovascular surgeons based on the anatomical and pathological indications. [15][16][17][18] The type of surgery was conventional open surgery in 75 patients and endovascular surgery with stent -graft placement in 227. Aortic surgery including stent -graft placement was performed under general anesthesia.…”

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confidence: 99%

Value of Pharmacologic Stress Myocardial Perfusion Imaging for Preoperative Risk Stratification for Aortic Surgery

Harafuji

Chikamori

Kawaguchi

et al. 2005

Circ J

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valuating the risk of perioperative cardiac events related to noncardiac surgery is important. [1][2][3][4][5][6][7][8][9] Preoperative myocardial perfusion imaging is useful for further stratification of the risk in moderate-and highrisk patients 3,4 because the redistribution findings can be used as predictive factors for cardiac events, and the technique has a high negative predictive value. [5][6][7][8] Moreover, recent studies suggest that the likelihood of cardiac events increases with the severity of the defect score on images evaluated semi-quantitatively 4,6-9 and guidelines for the perioperative cardiovascular evaluation of noncardiac surgery patients were recently published by the ACC/AHA, providing a framework for weighting the cardiac risk of noncardiac surgery based on patients' risk profiles and the type of operation. 10 Of the procedures, aortic surgery is claimed to be high-risk (the reported cardiac risk is often ≥5%), not only because it is highly invasiveness surgery but also because of the high prevalence of coronary artery disease in patients with aortic diseases. 10-12 However, there are few studies regarding preoperative risk stratification in Japanese patients who undergo aortic surgery. 13,14 Thus, the present study evaluated whether perioperative cardiac events related to aortic surgery can be predicted by preoperative pharmacologic stress myocardial perfusion imaging. Methods SubjectsThe subjects of this study were 302 consecutive patients who underwent elective aortic surgery after pharmacologic stress single-photon emission computed tomography (SPECT) between January 1998 and August 2003. SPECT study was performed in all patients unless contraindications such as bronchial asthma and advanced heart block were present. There were 261 men and 41 women, aged 71±10 years (35-86 years); 128 of them (42%) were aged 75 years or older. Medical history of angina pectoris was noted in 19 patients, myocardial infarction (MI) in 26, and heart failure in 5; 19 of them had undergone coronary revascularization. Hypertension was found in 217 patients, hypercholesterolemia in 73, diabetes mellitus (DM) in 55, and renal insufficiency defined as serum creatinine level ≥2.0 mg/dl in 20.The etiologies of the aortic diseases were type B aortic dissection in 56 patients, thoracic aortic aneurysm in 124, and abdominal aortic aneurysm in 122. The indication for aortic surgery was decided by cardiovascular surgeons based on the anatomical and pathological indications. [15][16][17][18] The type of surgery was conventional open surgery in 75 patients and endovascular surgery with stent -graft placement in 227. Aortic surgery including stent -graft placement was performed under general anesthesia. Approval to perform the endovascular surgery was obtained from the Ethical Committee of Tokyo Medical University. Written informed consent was obtained from all of the patients. Stress Myocardial ScintigraphyPharmacologic stress SPECT was performed ≥15 h after Background Aortic surgery is an invasive, high-risk noncard...

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Endoluminal stent grafting of the thoracic aorta: Initial experience with the Gore Excluder

Cited by 81 publications

References 28 publications

Tratamiento endovascular del trauma de aorta descendente

Tratamiento endovascular del trauma de aorta descendente

Endovascular treatment of thoracic aortic aneurysms

Value of Pharmacologic Stress Myocardial Perfusion Imaging for Preoperative Risk Stratification for Aortic Surgery

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