The bird beak configuration has no adverse effect in a magnetic resonance functional analysis of thoracic stent grafts after traumatic aortic transection

Oberhuber, Alexander; Schabhasian, David; Kohlschmitt, Robert; Rottbauer, Wolfgang; Orend, Karl-Heinz; Rasche, Volker

doi:10.1016/j.jvs.2014.09.024

Cited by 7 publications

(11 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our work also showed that the BBC does not appear to be associated with an increased risk of collapse/infolding or endograft thrombosis. This finding implies that the magnitude of the hemodynamic disturbances induced by the misalignment of the endograft, consistent with previous functional studies specifically performed in trauma patients, 12 may not per se induce complete endograft failure. Yet, displacement forces are greater in aneurysmal aortas compared with healthy aortas (ie, nondilated aortas such as in trauma patients) in zone 3, 7 and therefore clinical outcomes may vary based on the indication for TEVAR and the choice of the proximal landing zone.…”

Section: Discussionsupporting

confidence: 90%

“…Full texts of 517 articles relevant to the study were retrieved and reviewed; no randomized trials were found, so no quality exclusion criteria were applied. Ultimately, 21 articles 1–3,9,12,14–29 were retrieved for qualitative analysis (Figure 2). Characteristics of the included studies are summarized in Table 1.…”

Section: Methodsmentioning

confidence: 99%

“…10 Since its first description in the literature in 2008, 11 the BBC has gained the ominous reputation of heralding inadequate endograft performance. 2 The literature, however, provides inconsistent evidence regarding its prognostic relevance, 3,12 and these controversial results are likely to be related to methodologic differences among the studies, including patients and type of endograft, and even the choice of the definition and grading of the BBC.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Impact of the Bird-Beak Configuration on Postoperative Outcome After Thoracic Endovascular Aortic Repair: A Meta-analysis

et al. 2019

View full text Add to dashboard Cite

Purpose: To investigate the association between the bird-beak configuration (BBC), a wedge-shaped gap between the undersurface of a thoracic endograft and the lesser curvature of the arch after thoracic endovascular aortic repair (TEVAR), and postoperative outcome after TEVAR. Methods: The study was performed according to the PRISMA guidelines. The PubMed, EMBASE, and Cochrane databases were searched to identify all case series reporting BBC after TEVAR between 2006 and April 2018. Data analysis was performed considering the difference in the risk of complications for presence vs absence of BBC. After screening 1633 articles, 21 studies were identified that matched the selection criteria; 12 of these reported detailed information to investigate the postoperative outcome using proportion meta-analysis with a random effects model. The pooled risk difference is reported with the 95% confidence interval (CI). Heterogeneity of the included studies was assessed with the I2 statistic (low 25%, medium 50%, high 75%). Results: Complications occurred within a range of 0 to 72 months in 14.7% (95% CI 7.4% to 27.3%) of patients with BBC and in 6.3% (95% CI 2.5% to 15.4%) of patients without BBC. A cumulative incidence could not be assessed. The summary risk difference was 11.1% (95% CI −0.1% to 22.3%, p=0.052). There was significant heterogeneity ( I2=85.6%). The Egger test did not show evidence of publication bias (p=0.975). When specifically considering type Ia endoleak and endograft migration, the risk difference between BBC and non-BBC patients was 8.2% (95% CI 0.3% to 16.1%, p=0.042; I2=69.0%). The specific risk difference for endograft collapse/infolding and thrombosis was 3.7% (95% CI −3.5% to 11.1%, p=0.308; I2=10.2%). Conclusion: At present the literature does not provide statistical evidence to establish an overall prognostic value of the BBC. Nevertheless, the BBC appears to be associated with a high risk of type Ia endoleak and endograft migration, which warrants specific and long-term surveillance. Clinically relevant values for BBC grading should be established to perhaps define indications for preemptive treatment based on the presence of BBC only.

show abstract

Section: Discussionsupporting

confidence: 90%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Impact of the Bird-Beak Configuration on Postoperative Outcome After Thoracic Endovascular Aortic Repair: A Meta-analysis

et al. 2019

View full text Add to dashboard Cite

show abstract

“…The occurrence of bird beak which was a risk factor for type Ia endoleak, depending on anatomy of the aortic arch and stiffness of the stents. 20 Boufi et al suggested that aortic angle of stent deployment zone more than 50° could be predictive of bird beak occurrence. 9 Many older generations of grafts were stiff and with big “z” rings and prone to lead to “bird beaking,” newer modifications helped significantly with the problem.…”

Section: Discussionmentioning

confidence: 99%

Unplanned stents in thoracic endovascular aortic repair for type B aortic dissection: A 16-year single-center report

et al. 2017

View full text Add to dashboard Cite

Background Unplanned stents in thoracic endovascular aortic repair mean additional stents implantation beyond the preoperative planning to achieve operation success. This study aimed to reveal the prevalence and consequences of unplanned stents in thoracic endovascular aortic repair for type B aortic dissection and explore the reasons, risk factors and solutions for unplanned stents. Methods Retrospectively analysis consecutive patients diagnosed as type B aortic dissection with initial tear originating distal from the left subclavian artery and underwent thoracic endovascular aortic repair from September 1998 to June 2014 in our center. Results Under the criteria, this study enrolled 322 patients, with 83 (25.8%) patients in unplanned group. The incidence rate of unplanned stents in thoracic endovascular aortic repair for type B aortic dissection in each year demonstrates as a bimodal curve. The curve showed that, 2003 and, 2004 was the first and highest peak and 2007 was the second peak. There was no difference in five-year survival rate between planned and unplanned patients (log-rank test, p = 0.994). The unplanned group had higher hospitalization expenses (142,699.08 ± 78,446.75 yuan vs. 175,238.58 ± 34,838.01 yuan; p = 0.019), longer operation time (104.50 ± 93.24 min vs. 179.08 ± 142.47 min; p < 0.001) and hospitalization time (17.07 ± 16.62 d vs. 24.00 ± 15.34 d; p = 0.001). The reasons for unplanned stents were type Ia endoleak (46 patients, 55.4%), bird beak (25 patients, 30.1%), and inappropriate shaping of stent (9 patients, 10.8%). Asymptomatic aortic dissection patients had higher incidence of unplanned stents. Short proximal neck length (2.66 ± 0.59 mm vs. 2.50 ± 0.51 mm; p = 0.016), short stent coverage length (154.62 ± 41.12 mm vs. 133.60 ± 44.33 mm; p = 0.002), and large distal stent oversize (75.44±10.77% vs. 82.68±15.80%; p <0.001) were risk factors for unplanned stents in thoracic endovascular aortic repair. Conclusion There are some special risk factors and reasons for unplanned stents in thoracic endovascular aortic repair for type B aortic dissection. Knowing these can we reduce the utilization of unplanned stents with appropriate methods.

show abstract

“…For further investigation a conventional angiography with pressure gradient measurement and a four-dimensional magnetic resonance imaging was performed. The quantitative flow measurements were obtained by means of a retrospective ECG gated cardiacphase resolved three-dimensional T1 weighted fast gradient echo acquisition [1,2].…”

Section: Case Blogmentioning

confidence: 99%

Visualization of an Aortic Coarctation, Induced by a Thoracic Stent Graft, Using 4D Magnetic Resonance Imaging

Knapsis¹,

Schelzig²,

Oberhuber³

2016

Ann Clin Lab Res

View full text Add to dashboard Cite

The bird beak configuration has no adverse effect in a magnetic resonance functional analysis of thoracic stent grafts after traumatic aortic transection

Abstract: Functional analysis showed no adverse long-term outcome of the bird beak configuration of stent grafts in the aortic arch after endovascular repair after blunt aortic injury.

Cited by 7 publications

References 19 publications

Impact of the Bird-Beak Configuration on Postoperative Outcome After Thoracic Endovascular Aortic Repair: A Meta-analysis

Impact of the Bird-Beak Configuration on Postoperative Outcome After Thoracic Endovascular Aortic Repair: A Meta-analysis

Unplanned stents in thoracic endovascular aortic repair for type B aortic dissection: A 16-year single-center report

Visualization of an Aortic Coarctation, Induced by a Thoracic Stent Graft, Using 4D Magnetic Resonance Imaging

Contact Info

Product

Resources

About