Mid-Term Results of Thoracic Endovascular Aneurysm Repair with Intentional Celiac Artery Coverage for Crawford Type I Thoracoabdominal Aortic Aneurysms with the TX2 Distal Component Endograft

Fukushima, Soichiro; Ohki, Takao; Kanaoka, Yuji; Ohta, Hiroyuki; Ohmori, Makiko; Momose, Masamichi

doi:10.1016/j.avsg.2019.11.030

Cited by 9 publications

(14 citation statements)

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“…Minimum endovascular requirements for a successful endovascular repair require a proximal sealing zone 2 cm distal to the left Piffaretti et al 16 common carotid artery and a distal sealing zone 2 cm proximal to the CA. 17 According to the literature, approximately 15% of patients with descending TAAAs have an insufficient distal sealing zone for thoracic endovascular aortic aneurysm repair (TEVAR) 20 whereas 4% to 14% of patients planned for endovascular repair of their aortic pathology undergo CAO to achieve successful distal EG fixation. 13,18 Our study correlates with the current bibliography, demonstrating 7.6% (175 of 2297 patients) of CAO in the included population.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, SMA patency must be ensured at the end of the procedure. 12 2 0 3 Mehta et al 13 3 0 3 Delle et al 14 2 0 3 Li et al 15 2 0 2 Rose et al 9 3 0 3 Piffaretti et al 16 3 0 3 Fukushima et al 17 2 0 3 King et al 10 3 0 2 Banno et al 18 2 0 3…”

Section: Discussionmentioning

confidence: 99%

“…Rational for treatment Hyhlik-Durr et al 11 Belenky et al 12 Mehta et al 13 Delle et al 14 Li et al 15 Rose et al 9 Piffaretti et al 16 Fukushima et al 17 King et al 10 Banno et al 18 Representativeness of the exposed cohort The exposed cohort was a selected population group Selection of the nonexposed cohort There was no comparative group Ascertainment of exposure…”

Section: Newcastle-ottawa Scale Itemmentioning

confidence: 99%

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Safety and Efficacy of Intentional Celiac Artery Coverage in Endovascular Management of Thoracoabdominal Aortic Diseases: A Systematic Review and Meta-analysis

et al. 2021

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Purpose: Thoracic endovascular aortic aneurysm repair (TEVAR) has emerged as an attractive alternative option in the treatment of thoracoabdominal aortic aneurysm (TAAA) diseases, reporting lower morbidity and mortality rates compared with open or hybrid repair. A challenging situation arises when the aneurysm involves the celiac artery (CA), precluding a safe distal landing zone. We investigated the safety and efficacy of CA coverage in the treatment of complex TAAA diseases during endovascular management. Materials and Methods: A review of the literature was conducted in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. The electronic bibliographic sources searched were MEDLINE and SCOPUS databases. Primary outcomes of interest were perioperative and 30-day mortality. Any type of endoleak, mesenteric ischemia, perioperative spinal cord ischemia, and reintervention rates were secondary end points. A random-effects meta-analysis was performed. Summary statistics of event risks were expressed as proportions and 95% confidence interval (CI). Results: Ten observational cohort studies published between 2009 and 2020, reporting a total of 175 patients, were eligible for quantitative synthesis. Indications for TEVAR were primary TAAAs in 82% of patients, aortic dissection in 14% of patients, type Ib endoleak after previous endograft deployment in 3% of patients, and penetrating aortic ulcer in 1 patient. Reintervention rate was 9% (95% CI, 4%–20%) and spinal cord ischemia was 7% (95% CI, 4%–-12%). Type II endoleak was the predominant type of endoleak in 10% of patients (95% CI, 4%–22%), followed by type I endoleak in 5% of patients (95% CI, 2%–12%) and type III endoleak in 1% (95% CI, 0%–16%) of patients. Mesenteric ischemia occurred in 6% of patients (95% CI, 3%–10%). Thirty-day mortality was 5% (95% CI, 2%–13%) and the pooled estimate for overall mortality was 21% (95% CI, 14%–31%). Conclusions: Celiac artery coverage during TEVAR is a challenging but feasible option for the treatment of TAAA diseases, providing acceptable morbidity and mortality rates. Demonstration of adequate visceral collateral pathways before definitive CA coverage is the sine quo non for the success of the technique.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Newcastle-ottawa Scale Itemmentioning

confidence: 99%

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Safety and Efficacy of Intentional Celiac Artery Coverage in Endovascular Management of Thoracoabdominal Aortic Diseases: A Systematic Review and Meta-analysis

et al. 2021

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“…13,27e36,38 Five studies performed an adjunctive procedure to the SMA pre-and or intraoperatively. 13,14,30,33,34 Study characteristics are summarised in Tables 1 and 2.…”

Section: Study Characteristicsmentioning

confidence: 99%

Coverage of the Coeliac Artery During Thoracic Endovascular Aortic Repair: A Systematic Review and Meta-Analysis

Hanna¹,

Lam²,

Agbeko³

et al. 2022

European Journal of Vascular and Endovascular Surgery

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“…We previously reported the clinical outcomes of endovascular repair for aortic disease including aortic dissection, and complex aortic aneurysms [1], [2]. However, we sometimes experience an additional treatment even after EVAR, caused by an endoleak (EL), endograft infection, or endograft material deterioration [3], [4], [5].…”

Section: Introductionmentioning

confidence: 99%

A reproducible swine model of a surgically created saccular thoracic aortic aneurysm

et al. 2021

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A reproducible swine thoracic aortic aneurysm (TAA) model is useful for investigating new therapeutic interventions. We report a surgical method for creating a reproducible swine saccular TAA model. We used eight female swine weighing 20-25 kg (LWD; ternary species). All procedures were performed under general anesthesia and involved left thoracotomy. Following aortic cross-clamping, the thoracic aorta was surgically dissected and the media and intima were resected, and the dissection plane was extended by spreading the outer layer for aneurysmal space. Subsequently, only the adventitial layer of the aorta was sutured. At 2 weeks after these procedures, angiography and computed tomography (CT) were performed. After follow-up imaging, the model animals were euthanized. Macroscopic, histological, and immunohistological examinations were performed. All model animals survived, and a saccular TAA was confirmed by follow-up imaging in all cases. The mean length of the shorter and the longer aortic diameter after the procedure were 14.01 ± 1.0 mm and 18.35 ±1.4 mm, respectively (p < 0.001). The rate of increase in the aortic diameter was 131.7 ±13.8 %, and the mean length of aneurysmal change at thoracic aorta was 22.4±1.9 mm. Histological examination revealed intimal tears and defects of elastic fibers in the media. Immunostaining revealed MMP-2 and MMP-9 expressions at the aneurysm site. We report our surgical method for creating a swine saccular TAA model. Our model animal may be useful to investigate new therapeutic interventions for aortic disease.

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Mid-Term Results of Thoracic Endovascular Aneurysm Repair with Intentional Celiac Artery Coverage for Crawford Type I Thoracoabdominal Aortic Aneurysms with the TX2 Distal Component Endograft

Cited by 9 publications

References 14 publications

Safety and Efficacy of Intentional Celiac Artery Coverage in Endovascular Management of Thoracoabdominal Aortic Diseases: A Systematic Review and Meta-analysis

Safety and Efficacy of Intentional Celiac Artery Coverage in Endovascular Management of Thoracoabdominal Aortic Diseases: A Systematic Review and Meta-analysis

Coverage of the Coeliac Artery During Thoracic Endovascular Aortic Repair: A Systematic Review and Meta-Analysis

A reproducible swine model of a surgically created saccular thoracic aortic aneurysm

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