U-Shape Kissing Chimney Thoracic Endovascular Aneurysm Repair for a Traumatic Arch Rupture in a Polytraumatized Patient

Hendriks, Jeroen; Brits, Tim; Zijden, Thijs van der; Monsieurs, Koenraad G.; Bock, Dina De; Paep, Rudi De

doi:10.12945/j.aorta.2015.14-044

Cited by 5 publications

(3 citation statements)

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“…Although therapeutic advances in intensive care medicine result in a higher number of ICU survivors, the overall ICU mortality decreased only very slightly over time due to the steadily increase of patients' age and the number of comorbidities upon ICU admission [3]. Also, the risk of severe neurological deficits in ICU patients remains high [4,5] particularly in survivors of an out-of-hospital cardiac arrest (OHCA). In consequence, long-term physical, neurological and mental health status of ICU survivors has become an increasing concern in recent years [6].…”

Section: Introductionmentioning

confidence: 99%

Post-intensive care syndrome in out-of-hospital cardiac arrest patients: A prospective observational cohort study

et al. 2022

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Introduction Intensive care unit patients are at risk for post-intensive care syndrome (PICS), which includes psychological, physical and/or cognitive sequelae after their hospital stay. Our aim was to investigate PICS in adult patients with out-of-hospital cardiac arrest (OHCA). Methods In this prospective observational cohort study, we assessed risks for PICS at 3 and 12-month follow-up within the following domains: a) physical impairment (EuroQol [EQ-5D-3L]), b) cognitive functioning (Cerebral Performance Category [CPC] score >1, modified Rankin Scale [mRS] >2) and c) psychological burden (Hospital Anxiety and Depression Scale [HADS], Impact of Event Scale-Revised [IES-R]). Results At 3 months, 69/139 patients (50%) met the definition of PICS including 37% in the physical domain, 25% in the cognitive domain and 13% in the psychological domain. Intubation (OR 2.3, 95%CI 1.1 to 5,0 p = 0.03), sedatives (OR 3.4, 95%CI 1 to 11, p = 0.045), mRS at discharge (OR 4.3, 95%CI 1.70 to 11.01, p = 0.002), CPC at discharge (OR 3.3, 95%CI 1.4 to 7.6, p = 0.005) and post-discharge work loss (OR 13.4, 95%CI 1.7 to 107.5, p = 0.014) were significantly associated with PICS. At 12 months, 52/110 (47%) patients had PICS, which was associated with prolonged duration of rehabilitation, higher APACHE scores, and higher mRS and CPC scores at hospital discharge. Conclusions Nearly half of long-term OHCA survivors show PICS after 3 and 12 months. These high numbers call for more emphasis on appropriate screening and treatment in this patient population. Future studies should evaluate whether early identification of these patients enables preventive strategies and treatment options.

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Section: Introductionmentioning

confidence: 99%

Post-intensive care syndrome in out-of-hospital cardiac arrest patients: A prospective observational cohort study

et al. 2022

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“…A cardiac arrest is a serious medical condition and often leads to adverse outcomes such as cognitive and functional disabilities and death [1][2][3]. Therefore, early risk stratification is important to decide about further treatment [4].…”

Section: Introductionmentioning

confidence: 99%

Association of Taurine with In-Hospital Mortality in Patients after Out-of-Hospital Cardiac Arrest: Results from the Prospective, Observational COMMUNICATE Study

Herzog

Laager

Thommen

et al. 2020

JCM

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Background: Studies have suggested that taurine may have neuro- and cardio-protective functions, but there is little research looking at taurine levels in patients after out-of-hospital cardiac arrest (OHCA). Our aim was to evaluate the association of taurine with mortality and neurological deficits in a well-defined cohort of OHCA patients. Methods: We prospectively measured serum taurine concentration in OHCA patients upon admission to the intensive care unit (ICU) of the University Hospital Basel (Switzerland). We analyzed the association of taurine levels and in-hospital mortality (primary endpoint). We further evaluated neurological outcomes assessed by the cerebral performance category scale. We calculated logistic regression analyses and report odds ratios (OR) and 95% confidence intervals (CI). We calculated different predefined multivariable regression models including demographic variables, comorbidities, initial vital signs, initial blood markers and resuscitation measures. We assessed discrimination by means of area under the receiver operating curve (ROC). Results: Of 240 included patients, 130 (54.2%) survived until hospital discharge and 110 (45.8%) had a favorable neurological outcome. Taurine levels were significantly associated with higher in-hospital mortality (adjusted OR 4.12 (95%CI 1.22 to 13.91), p = 0.02). In addition, a significant association between taurine concentration and a poor neurological outcome was observed (adjusted OR of 3.71 (95%CI 1.13 to 12.25), p = 0.03). Area under the curve (AUC) suggested only low discrimination for both endpoints (0.57 and 0.57, respectively). Conclusion: Admission taurine levels are associated with mortality and neurological outcomes in OHCA patients and may help in the risk assessment of this vulnerable population. Further studies are needed to assess whether therapeutic modulation of taurine may improve clinical outcomes after cardiac arrest.

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“…Currently, as chimney or fenestration techniques are used as assistive techniques, the indications for TEVAR have obviously expanded 4 .Since 2002, chimney TEVAR has been reported to be used successfully for different types of aortic arch diseases 5,6 . However, for the treatment of aortic arch pseudoaneurysms, the current literature on chimney TEVAR is limited [7][8][9][10][11][12][13][14][15][16][17][18] . The aim of this retrospective study is to report the mid-term results of chimney TEVAR for aortic arch pseudoaneurysms in our centre.…”

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confidence: 99%

Endovascular Aortic Arch Repair with Chimney Technique for Pseudoaneurysm

Luo

Zhang

Fang

et al. 2022

Preprint

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Background: Aortic pseudoaneurysm is a life-threatening clinical condition, and thoracic endovascular aortic repair (TEVAR) has been reported to have a relatively satisfactory effect in aortic pathologies. We summarized our single-centre experience using chimney TEVAR for aortic arch pseudoaneurysms with inadequate landing zones.Methods: A retrospective study was conducted from October 2015 to August 2020, 32 patients (64.1±15.0 years, range 28-81; 29 men) with aortic arch pseudoaneurysms underwent chimney TEVAR to exclude an aortic lesion and reconstruct the supra-aortic branches, including 3 innominate artery, 12 left common carotid arteries and 29 left subclavian arteries. Follow-up computed tomography was suggested before discharge; at 3, 6, and 12 months; and yearly thereafter.Results: Forty-four related supra-aortic branches were well preserved and the technical success rate was 100%. The Type Ia endoleaks occurred in 3 (9%) patients. Two patients were lost to follow-up and 4 patients died during the follow-up period. The median follow-up was 46.5±14.3 (range, 4.5-60) months. One patient died due to acute myocardial infarction just 10 days after chimney TEVAR and the other 3 patients passed away at 1.5 months, 20 months and 31 months with non-aortic reasons. The 4.5-year survival estimate was 84.4%. The primary patency rate of the target supra-arch branch vessels was 97.7% (43/44), and no other aorta-related reinterventions and severe complications occurred.Conclusion: For aortic arch pseudoaneurysms with inadequate landing zones for TEVAR, the chimney technique seems to be feasible, with acceptable mid-term outcomes, and it could serve as an alternative minimally invasive approach to extend the landing zone. Slow flow type Ia endoleak could be treated conservatively after chimney TEVAR. Additional experience is needed, and the long-term durability of chimney TEVAR requires further follow-up.

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U-Shape Kissing Chimney Thoracic Endovascular Aneurysm Repair for a Traumatic Arch Rupture in a Polytraumatized Patient

Cited by 5 publications

References 1 publication

Post-intensive care syndrome in out-of-hospital cardiac arrest patients: A prospective observational cohort study

Post-intensive care syndrome in out-of-hospital cardiac arrest patients: A prospective observational cohort study

Association of Taurine with In-Hospital Mortality in Patients after Out-of-Hospital Cardiac Arrest: Results from the Prospective, Observational COMMUNICATE Study

Endovascular Aortic Arch Repair with Chimney Technique for Pseudoaneurysm

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