Early experience with off-the-shelf endografts using a zone 0 proximal landing site to treat the ascending aorta and arch

Bernardes, Rodrigo C.; Navarro, Túlio Pinho; Reis, Fernando; Lima, Luiz Cláudio Moreira; Monteiro, Ernesto Lentz da Silveira; Procópio, Ricardo Jayme; Botelho, Francesco Evangelista; Dardik, Alan

doi:10.1016/j.jtcvs.2013.07.049

Cited by 41 publications

(47 citation statements)

References 17 publications

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“…Of these, 39 full‐text articles were assessed for eligibility. Finally, nine studies were included in the systematic review according to the inclusion criteria …”

Section: Resultsmentioning

confidence: 99%

Systematic review of endovascular repair of ascending aortic dissection

Zhang

et al. 2019

Cathet Cardio Intervent

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Background Endovascular repair has been used in selected ascending aortic dissection patients judged unfit for direct open surgery. However, the selective criteria and the results of endovascular repair of ascending aortic dissection, and the potential risk factors of adverse events were still obscure. The aim of this study was to summarize the published data linking endovascular therapy for ascending aortic dissection. Methods Studies reporting endovascular repair of ascending aortic dissections were identified by searching PubMed and Embase databases in accordance with preferred reporting items for systematic reviews and meta‐analyses guidelines, and by reviewing the reference lists of retrieved articles. All available data were pooled and the subgroup analyses were conducted. Results A total of nine studies were identified according to the inclusion criteria. The overall technical success was 91.7%. The mean period of follow‐up was 34.7 months. The early mortality within 30 days and late mortality during the follow‐up were 10.3% and 19.0%, respectively. The incidence of endoleak was 14.3%. In the subgroup analysis, we found that female and oversizing >10% were risk factors of adverse events. Conclusions The pooled results suggested that endovascular repair of ascending aortic dissection was feasible, promising, and inspiring. The selection of endovascular therapy should be cautious based on preoperative evaluation. Application of different strategies for different ascending lesions should be considered. The dedicated endograft for ascending aorta is desperately needed before broader application of endovascular repair for ascending aortic pathologies can be achieved.

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“…Of these, 39 full‐text articles were assessed for eligibility. Finally, nine studies were included in the systematic review according to the inclusion criteria …”

Section: Resultsmentioning

confidence: 99%

Systematic review of endovascular repair of ascending aortic dissection

Zhang

et al. 2019

Cathet Cardio Intervent

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“…The experience with thoracic endovascular aortic repair of ascending aortic aneurysms and dissections remains scarce (Table 1). 3,[8][9][10][11][12] There is no specifically designed stent-graft, and most reported cases have used abdominal or thoracic stent-graft extensions under off-label indication. These devices are limited by an inadequate delivery system and lack of controlled deployment.…”

Section: Discussionmentioning

confidence: 99%

Endovascular Repair of Saccular Ascending Aortic Aneurysm After Orthotopic Heart Transplantation Using an Investigational Zenith Ascend Stent-Graft

et al. 2015

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The ideal ascending aortic stent-graft should be low profile, conformable to the arch anatomy, with short tip delivery system and a stepwise deployment mechanism that allows precise placement relative to the ostia of the coronary arteries and the innominate artery. This case illustrates the advancement of endovascular techniques to the most challenging segment of the aorta to decrease morbidity and mortality in high-risk patients.

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“…However, the use of TEVAR in the ascending aorta particularly in the setting of acute aortic dissection remains experimental (7). In fact, since the first successful endovascular ascending aortic repair in 2000, the largest case series consists of 45 patients that were treated with ascending aortic TEVAR and most reports consist only of few patients in high volume centers (4,(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19). Also, reports are either due to a favorable anatomy or due to very localized disease processes, which are the exception and not the rule.…”

Section: Introductionmentioning

confidence: 99%

Endovascular treatment of acute Type A aortic dissection—the Endo Bentall approach

et al. 2018

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Outcome after classical surgical repair of acute Type A aortic dissection has steadily improved over the years and several modifications in cannulation and perfusion added to this achievement. However, subgroups remain where results of classical surgical repair still have room for improvement, particularly patients with severe preoperative malperfusion as well as elderly patients with a limited physiological reserve. So far, only small case series or case reports have been published on the endovascular treatment of dissected ascending aortas. However, a tube alone is not sufficient to fix the entire complex underlying problem in the vast majority of patients with acute Type A aortic dissection. In addition, these published reports are either due to a favorable anatomy or due to very localized disease processes, which are the exception and not the rule. The concept of an endovascular valve-carrying conduit may significantly increase the number of patients suitable for endovascular therapy and it may soon be common practice.

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Early experience with off-the-shelf endografts using a zone 0 proximal landing site to treat the ascending aorta and arch

Abstract: Endovascular treatment of the ascending aorta is feasible. We had 4 good mid-term results in 7 patients who had presented with penetrating ulcers or aneurysm formation. Acute dissections seem to be more unstable, and additional research is mandatory.

Cited by 41 publications

References 17 publications

Systematic review of endovascular repair of ascending aortic dissection

Systematic review of endovascular repair of ascending aortic dissection

Endovascular Repair of Saccular Ascending Aortic Aneurysm After Orthotopic Heart Transplantation Using an Investigational Zenith Ascend Stent-Graft

Endovascular treatment of acute Type A aortic dissection—the Endo Bentall approach

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