Introduction of adjuncts and their influence on changing results in 402 consecutive thoracoabdominal aortic aneurysm repairs☆

Schepens, Marc A.A.M.; Dossche, Karl M.; Morshuis, Wim J.; Heijmen, Robin H.; Dongen, Eric van; Beek, Huub T. ter; Kelder, Hans; Boezeman, Eduard H.

doi:10.1016/j.ejcts.2004.01.033

Cited by 84 publications

(60 citation statements)

References 22 publications

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“…Although the contemporary results of these extensive operations are considered acceptable in the context of the untreated risk of aneurysm rupture, such an undertaking remains daunting for the patient and physician. Patients selected to undergo such a repair are faced with a mortality risk ranging from 3% to 17%, [2][3][4][5][6] with an incidence of perioperative death at centers with extensive experience Ͻ10%. The risk of spinal cord ischemia, despite the variety of adjuncts that may be employed, remains substantial, between 4% and 11%.…”

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confidence: 99%

Endovascular Repair of Thoracoabdominal Aneurysms

2008

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Background-Morbidity and mortality after conventional repair of thoracoabdominal aneurysms remain high. Alternative techniques have been proposed and are the subject of this report. Methods and Results-Endovascular grafts that have a means of incorporating the visceral vessels into the aortic repair were divided into devices with fenestrations and those with formal branches. Hybrid procedures whereby an extra-anatomic bypass procedure is used to provide inflow to the renal and mesenteric arteries followed by aortic relining with stent grafts were reviewed and tabulated. A description of the techniques and review of the current results are provided. Only 4 series with Ͼ10 cases of hybrid procedures have been published. The experience with such a procedure suggests feasibility, but most reports describe a persistently high risk of mortality (up to 25%). Larger series of fenestrated stent grafts to treat juxtarenal aneurysms have been published, and intermediate-term results confirm the safety and efficacy of the procedure. A larger multicenter trial is under way. Other pure endovascular methods have been used to treat thoracoabdominal aneurysms with both reinforced fenestrations and directional branches. Without counting small series (Ͻ10 cases), 2 series exist with Ϸ100 cases that noted perioperative mortality rates between 3% and 6%, without evidence of late ruptures. Conclusions-Endovascular repair of thoracoabdominal aneurysms is feasible and is associated with relatively low perioperative mortality. Several methods of visceral vessel incorporation have been described. Because of persistently high mortality, hybrid procedures will likely be relegated to nonsurgical and nonendovascular patients with sizable aneurysms. Endografts with branches continue to evolve and will be assessed in the context of clinical trials.

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confidence: 99%

Endovascular Repair of Thoracoabdominal Aneurysms

2008

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“…Crawford et al [12] 1986 605 8,9% 11,4% (6,6/4,8%) 17% Cox [11] 1992 129 35% (15%) 21% (15,8/5,2%) 27% Svensson et al [32] 1993 1509 8% 16% 9% Schepens et al [29] 1994 88 5,9% 13,8% (5,8/8%) 14,1% Grabitz et al [18] 1996 222 12,2% 15,8% (4,5%/11,3%) 10,4% Cina et al [3] 2002 121 21,4% (12%) 6,2% (4,4%/1,8%) 15% Cambria et al [2] 2002 337 8,3% (6,7%) 11,4% (6,6%/4,8%) 4,8% Rectenwald et al [24] 2002 101 17,8% a (10,3% a ) 10,3% k.A. Jakobs et al [20] 2002 184 10,8% 2,7% k.A.…”

Section: Tab 8 Literaturübersicht Großer Studien üBer Den Offen-chirmentioning

confidence: 99%

Offen-chirurgische Therapie thorakoabdomineller Aortenaneurysmen und chronisch expandierender Aortendissektionen

Kotelis

Riemensperger

Jenetzky

et al. 2010

Chirurg

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“…Развитие методов интраоперационного мониторинга и защиты внутренних органов, а также хирургической техники и используемых протезов позволило значительно снизить госпитальную летальность [5][6][7][8][9][10]. Несмотря на это, периоперацион-ная летальность при открытых вмешательствах на торакоабдоминальном отделе аорты по данным различных авторов составляет 8,4-30%, перманент-ная параплегия достигает 1,5-6,6%, а частота почеч-ной недостаточности в послеоперационном периоде, требующей гемодиализа -до 14,3%, частота разви-тия инсульта в послеоперационном периоде дости-гает 6,3% [11,12].…”

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Shereshevsky-Turner Syndrome in Aortic Surgery: An Example of Hybrid Aneurism Treatment and Dissection of Thoracoabdominal Aorta

Чарчян¹,

Абугов²,

Поляков³

et al. 2015

Russ J Cardiol

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Синдром Шерешевского-Тернера -это хромосомное заболевание, моносо-мия по Х-хромосоме (кариотип 45, Х0), которое встречается с частотой 1:2000-1:2500 новорожденных девочек. Как известно, у этих пациенток часто выявляется патология сердечно-сосудистой системы. Аневризма аорты выяв-ляется у данной группы пациентов в 100 раз чаще, чем в популяции. другой особенностью течения заболевания является высокий риск развития расслое-ния аорты, причем при относительно меньшем диаметре аорты, чем в сред-нем при расслоениях. в настоящее время можно рассматривать различные методики лечения патологии аорты у больных с данным синдромом: традици-онные открытые вмешательства, эндоваскулярное лечение и гибридные опе-рации. в статье представлен пример успешного применения гибридной тех-нологии у пациентки 58 лет с синдромом Шерешевского-Тернера, аневризмой торакоабдоминального отдела аорты и расслоением нисходящего грудного и брюшного отделов аорты. Представленный клинический пример показывает, что гибридная методика позволяет выполнить радикальное вмешательство на аорте, снизив при этом травматичность операции, летальность и частоту осложнений в периоперационном периоде. Shereshevsky-Turner syndrome -is chromosome anomaly, the monosomia by X-chromosome (cariotype 45, X0) that has prevalence 1:2000-1:2500 newborn girls. It is well known that these patients very often have cardiovascular pathology. Aortic aneurysm is 100 times more common than in general population. Another significant specifics is the high risk of aortic dissection even with relatively small diameter of aorta, than in average for the dissections. Currently it is common to concern a variety of aortic pathology treatment ways in patients with the syndrome: traditional open-chest interventions, endovascular treatment, hybrid operations. The article provides an example of successful usage of the hybrid method in women 58 years old with Shereshevsky-Turner syndrome, thoracoabdominal aortic aneurysm and dissection of descending thoracal and abdominal aorta parts. The clinical example shows that hybrid method makes it to perform radical intervention on aorta, decreasing traumaticity of operation, mortality and complications rate in postoperation period. Russ

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Introduction of adjuncts and their influence on changing results in 402 consecutive thoracoabdominal aortic aneurysm repairs☆

Abstract: The use of different adjuncts introduced over the years clearly influenced our results in a positive way.

Cited by 84 publications

References 22 publications

Endovascular Repair of Thoracoabdominal Aneurysms

Endovascular Repair of Thoracoabdominal Aneurysms

Offen-chirurgische Therapie thorakoabdomineller Aortenaneurysmen und chronisch expandierender Aortendissektionen

Shereshevsky-Turner Syndrome in Aortic Surgery: An Example of Hybrid Aneurism Treatment and Dissection of Thoracoabdominal Aorta

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