Hybrid treatment of aortic dissection associated with Kommerell's diverticulum

Kozlov, B. N.; Panfilov, D. S.; Саушкин, В. В.; Shipulin, V. M.

doi:10.1093/icvts/ivw031

Cited by 6 publications

(4 citation statements)

References 3 publications

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“…Subsequently, increasing experience with TEVAR has paved the way for less invasive hybrid approaches. However, even hybrid repair (HR) still needs thoracotomy or sternotomy and replacement of the ascending aorta, which may still lead to multiple complications due to vast exposure and strict operative conditions during the long surgery [ 42 ].…”

Section: Discussionmentioning

confidence: 99%

A Systematic Review of Total Thoracic Endovascular Aortic Repair in Treatment of Kommerell Diverticulum Combined with Right-Sided Aortic Arch

et al. 2021

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Kommerell diverticulum (KD) combined with right-sided aortic arch (RAA) and aberrant left subclavian artery (ALSA) are rare and limited to a few case reports and small series. Thoracic endovascular aortic repair (TEVAR), which is mini-invasive, is widely utilized in complicated aortic disease. We performed a systematic review of the literature to identify all patients who underwent endovascular repair for KD in terms of technical feasibility and procedural outcomes. Published and accepted studies only in English as well as article reference lists were searched and extracted to assess case series reporting solely TEVAR in KD patients. There were 28 patients with KD/RAA identified from 19 studies. All of them underwent endovascular technique for KD exclusion and the median age was 69 years (range 39–83 years). Hypertension (n=17) was the most common comorbidity in this cohort, followed by diabetes mellitus (n=3), hyperlipidemia (n=3), and smoking (n=3). The presenting symptoms were dysphagia (n=8, 29%), intermittent back pain (n=4, 14%), and acute aortic dissection (n=6, 21%), while asymptomatic was found in 9 patients (n=9, 32%). A technical success rate of 100% was reported associated with various managements of ALSA, proximal embolization (n=19, 68%), in-situ revascularization (n=3, 11%), and left carotid-subclavian bypass (n=3, 11%). All patients survived without severe complications and were discharged home within less than 14 days. The mean follow-up time was 9.3 months, patency was found in all patients, thrombosis and distinct shrinkage of KD aneurysm as indicated by CT-scans were noted (n=20, 71%), and type II endoleak was found in only 4 patients (n=4, 14%). TEVAR appears to be safe and offers favorable results, but it still needs substantial evidence to support routine use in KD. TEVAR is an alternative to open repair in selected cases, but it needs further investigation in a large cohort.

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Section: Discussionmentioning

confidence: 99%

A Systematic Review of Total Thoracic Endovascular Aortic Repair in Treatment of Kommerell Diverticulum Combined with Right-Sided Aortic Arch

et al. 2021

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“…Moreover "steep aortic arch", which is one of the characteristic of RAA, might result in increasing risk of kinking of stent graft or retrograde type A dissection [4]. Hybrid procedure, firstly total arch replacement with elephant trunk (ET) followed by TEVAR and single stage repair using FET, have also been reported [5]. However, single stage repair using long FET or ET might be accompanied with the risk of spinal cord injury.…”

Section: Discussionmentioning

confidence: 99%

Staged Hybrid Repair for Acute Type B Aortic Dissection of Right-Sided Aortic Arch

Shibukawa¹,

Yamauchi²,

Masai³

2017

Vasc Med Surg

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“…In the last few decades, only a few case reports have been published. Several strategies, such as total arch replacement, 2 stent elephant trunk, 3 thoracic endovascular aortic repair (TEVAR), 4 chimney technique, 5,6 and a hybrid procedure, 7 have been reported as management options for pathology. However, there is no consensus on the optimal treatment strategy for coexistence of TBAD and an ARSA owing to the rarity of cases.…”

mentioning

confidence: 99%

Outcomes of hybrid procedure for type B aortic dissection with an aberrant right subclavian artery

Ding

Luo

Liu

et al. 2018

Journal of Vascular Surgery

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Hybrid treatment of aortic dissection associated with Kommerell's diverticulum

Cited by 6 publications

References 3 publications

A Systematic Review of Total Thoracic Endovascular Aortic Repair in Treatment of Kommerell Diverticulum Combined with Right-Sided Aortic Arch

A Systematic Review of Total Thoracic Endovascular Aortic Repair in Treatment of Kommerell Diverticulum Combined with Right-Sided Aortic Arch

Staged Hybrid Repair for Acute Type B Aortic Dissection of Right-Sided Aortic Arch

Outcomes of hybrid procedure for type B aortic dissection with an aberrant right subclavian artery

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