Partial debranching hybrid stent graft for distal aortic arch aneurysms

Ishibashi, Hiroyuki; Ishiguchi, Tsuneo; Ohta, Takashi; Sugimoto, Ikuo; Iwata, Hirohide; Yamada, Tetsuya; Tadakoshi, Masao; Hida, Noriyuki; Orimoto, Yuki

doi:10.1007/s00595-012-0139-3

Cited by 3 publications

(2 citation statements)

References 23 publications

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“…Thoracic endovascular aortic repair (TEVAR) combined with extra-anatomic bypass is a minimally invasive technique enabling to overcome the coverage of supra-arch branch ( 1 ). This hybrid procedure extends the indications for endovascular treatment, and is gradually being used to treat distal aortic arch disease ( 2 ). Although open arch repair correlated with higher perioperative mortality and complications ( 3 ), our previous studies demonstrated that open arch repair combined with supra-arch branch reconstruction also achieved excellent results to manage distal arch disease ( 4 , 5 ).…”

Section: Introductionmentioning

confidence: 99%

Comparison of Open Repair vs. the One-Stage Hybrid Extra-Anatomic Technique for Distal Aortic Arch Disease Treatment: Mid-term Outcomes With a Risk-Adjusted Analysis

Qiao

Chen

Guo

et al. 2021

Front. Cardiovasc. Med.

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Objective: This study aims to compare the short- and mid-term outcomes of the stented elephant trunk (SET) procedure combined with supra-arch branch reconstruction and one-stage hybrid arch repair combined thoracic endovascular aortic repair (TEVAR) with extra-anatomic bypass in the management of distal arch disease.Methods: From January 2009 to January 2019, 97 patients underwent one-stage hybrid arch repair combined with TEVAR with extra-anatomic bypass (HAR group), and 206 patients underwent the SET procedure with supra-arch branch reconstruction (SET group). We used inverse-probability-of treatment weighting (IPTW) to adjust baseline differences.Results: Before IPTW adjustment, there was no significant difference in operative mortality between the two groups (5.2 vs. 1.0%, P = 0.064). The incidences of stroke, spinal cord injury (SCI), acute kidney injury (AKI), and endoleak also showed no significant differences (4.1 vs. 0.5%, P = 0.066; 2.1 vs. 1.5%, P = 1.000; 0 vs. 1.0%, P = 0.831; 6.2 vs. 1.9%, P = 0.113, respectively). After IPTW adjustment, the incidences of stroke, SCI, and AKI showed no significant differences between the two groups (1.8 vs. 1.1%, P = 0.138; 0.8 vs. 1.6%, P = 0.448; and 0 vs. 0.7%, P = 0.148, respectively). However, the HAR group tended to have higher operative mortality and incidence of endoleak than the SET group (12.4 vs. 1.3%, P = 0.01; 9.9 vs. 1.8%, P = 0.031, respectively). In the multivariate analysis, open repair decreased the risks of endoleak (odds ratio [OR], 0.171, 95% CI, 0.060–0.401; P < 0.001) and operative mortality (OR, 0.093, 95% CI, 0.027–0.238; P < 0.001). The overall survival and event-free survival of the HAR group were significantly lower than those of the SET group (P < 0.001).Conclusion: One-stage hybrid arch repair combined TEVAR with extra-anatomic bypass and the SET procedure with supra-arch branch reconstruction both provided good postoperative treatment outcomes for distal arch disease. However, hybrid arch repair increased the risks of endoleak and operative mortality. The SET procedure provided better mid-term survival than hybrid arch repair without increasing operative mortality. Carefully selecting the indications for the procedure, while receiving close long-term follow-up, may improve the survival rate of patients undergoing hybrid arch repair.

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Section: Introductionmentioning

confidence: 99%

Comparison of Open Repair vs. the One-Stage Hybrid Extra-Anatomic Technique for Distal Aortic Arch Disease Treatment: Mid-term Outcomes With a Risk-Adjusted Analysis

Qiao

Chen

Guo

et al. 2021

Front. Cardiovasc. Med.

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“…The thoracic aorta is a challenging segment for endovascular repair procedures for various reasons, most important of which is the origin of the coronary and carotid arteries. Safe stent graft implantation may require aortic debranching and reimplantation of all three or sometimes the sole left subclavian artery, or both the left common carotid and left subclavian arteries, depending on the proximal landing zone of the stent graft [1][2][3]. Cerebral perfusion is vitally important for an uneventful outcome during debranching.…”

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confidence: 99%

Cerebral Protection With a Crossover External Carotid Artery Bypass During Arch Debranching

Uğurlucan

Sayın

Önalan

et al. 2015

The Annals of Thoracic Surgery

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Zone 1 Aortic Arch Hybrid Endovascular Repair with Extra-anatomical Bypass: A Meta-analysis

Bayfield

Melamed

Bayfield

et al. 2021

Annals of Vascular Surgery

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Partial debranching hybrid stent graft for distal aortic arch aneurysms

Abstract: It was possible to achieve a longer proximal landing zone by debranching two supra-aortic branches, the LCCA and the LSA. The partial debranching hybrid stent graft was less invasive and more effective for DAAAs.

Cited by 3 publications

References 23 publications

Comparison of Open Repair vs. the One-Stage Hybrid Extra-Anatomic Technique for Distal Aortic Arch Disease Treatment: Mid-term Outcomes With a Risk-Adjusted Analysis

Comparison of Open Repair vs. the One-Stage Hybrid Extra-Anatomic Technique for Distal Aortic Arch Disease Treatment: Mid-term Outcomes With a Risk-Adjusted Analysis

Cerebral Protection With a Crossover External Carotid Artery Bypass During Arch Debranching

Zone 1 Aortic Arch Hybrid Endovascular Repair with Extra-anatomical Bypass: A Meta-analysis

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