Endovascular Stent Grafting for Acute Thoracic Aortic Pathology

Albors, José; Bahamonde, José A.; Juez, Marina; Alcocer, Jorge; Boix, Ricardo; Rueda, Cristina; Martín, Iván; Tébar, Eduardo; Palmero, Julio

doi:10.1111/j.1540-8191.2009.00920.x

Cited by 7 publications

(7 citation statements)

References 31 publications

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“…[1][2][3][4][5] Other centers have also demonstrated the safety and effectiveness of TEVAR for the repair of acute complicated type B aortic dissection. 1,6,7,15,16 Younes and colleagues 7 reported an overall 30-day mortality of 5.5% after TEVAR. Khoynezhad and associates 14 reported 82% and 78% mortalities 1 and 5 years after TEVAR.…”

Section: Discussionmentioning

confidence: 99%

Thoracic endovascular aortic repair for acute complicated type B aortic dissection: Superiority relative to conventional open surgical and medical therapy

Ahmad

Woo

Bavaria

et al. 2010

The Journal of Thoracic and Cardiovascular Surgery

162

102

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Section: Discussionmentioning

confidence: 99%

Thoracic endovascular aortic repair for acute complicated type B aortic dissection: Superiority relative to conventional open surgical and medical therapy

Ahmad

Woo

Bavaria

et al. 2010

The Journal of Thoracic and Cardiovascular Surgery

162

102

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“…29 Therefore, a patient-specific approach is currently advised for TEVAR in TBAD, treating only patients with complications or those suspected of complications during follow-up. 31 TEVAR has been reported as feasible following acute catastrophes, such as ruptured TBAD, 33,34 as well as in Marfan patients. 35 However, Marfan aortas tend to dilate after TEVAR, 36 and reintervention rates are higher in this cohort.…”

Section: Introductionmentioning

confidence: 99%

Biomechanical Changes After Thoracic Endovascular Aortic Repair in Type B Dissection

et al. 2015

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Thoracic endovascular aortic repair (TEVAR) has evolved into an established treatment option for type B aortic dissection (TBAD) since it was first introduced 2 decades ago. Morbidity and mortality have decreased due to the minimally invasive character of TEVAR, with adequate stabilization of the dissection, restoration of true lumen perfusion, and subsequent positive aortic remodeling. However, several studies have reported severe setbacks of this technique. Indeed, little is known about the biomechanical behavior of implanted thoracic stent-grafts and the impact on the vascular system. This study sought to systematically review the performance and behavior of implanted thoracic stent-grafts and related biomechanical aortic changes in TBAD patients in order to update current knowledge and future perspectives.

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“…A number of authors have had satisfactory results in their small series of type B dissections treated with this relatively new procedure. [1,5,6,12,13] Svensson et al [4] did a meta-analysis on the endovascular treatment of thoracic aortic pathologies, and TEVAR was highly recommended in cases of type B dissections with ischemic complications. In our group, 15 patients were operated on because of complications associated with the dissection, and the mortality rate was 13% (n=2).…”

Section: Discussionmentioning

confidence: 99%

“…Despite improvements in surgical therapy and postoperative care of thoracic aortic diseases, morbidity and mortality rates are still high, especially in emergency cases. [1] The term acute aortic syndrome (AAS) defines a group of life-threatening thoracic aortic pathologies, including aortic dissection with malperfusion or rupture, intramural hematoma (IMH), penetrating atherosclerotic ulcer (PAU), traumatic aortic transection (TAT), aortitis, and ruptured descending aortic aneurysm. [2] If not treated, the risk of mortality in this group increases every hour.…”

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confidence: 99%

Thoracic endovascular aortic repair for acute pathologies of descending thoracic aorta

Ertugay¹

2013

Turk Gogus Kalp Dama

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Amaç: Bu çalışmada inen aortun akut patolojilerinde uygulanan torasik endovasküler aort tamiri işleminin erken ve orta dönem sonuçları analiz edildi. Ça lış mapla nı:Eylül 2006 -Nisan 2010 tarihleri arasında kliniğimizde endovasküler yöntemle acil olarak ameliyat edilmiş olan 25 akut aortik sendrom hastası (21 erkek, 4 kadın; ort. yaş 62.1±14.8 yıl; dağılım 26-82 yıl) çalışmaya dahil edildi. Hastaların demografik özellikleri, ameliyat öncesi ve ameliyat sonrası verileri dosya tarama yöntemi ile retrospektif olarak analiz edildi. Bul gu lar: Tüm hastalarda işlem başarısı sağlandı. Yirmi beş hastaya toplam 29 adet torasik endogreft yerleştirildi. Üç hasta (12%) hastaneden taburcu edilmeden önce kaybedildi. Bu işlemin ana komplikasyonları olan nörolojik olay veya tip 1 kaçak, hiçbir hastada görülmedi. Ortalama takip süresi 20.2±16.8 ay idi. Bu sürede hiçbir hastada işleme bağlı komplikasyon görülmezken, penetran aterosklerotik ülser nedeniyle tedavi edilmiş bir hasta 20. ayda maligniteye bağlı olarak kaybedildi. So nuç:Çalışmamız retrospektif olarak hazırlanmış olmasına ve kısıtlı sayıda olgu içermesine rağmen, analizlerde düşük morbidite ve mortalite oranları saptandı. Sonuçlar literatür ile paralellik göstermekle beraber, güvenilirlik açısından uzun dönem sonuçlara gereksinim duyulmaktadır. Torasik endovasküler aort tamiri, inen aortun akut patolojilerinin tedavisinde uygulanabilir bir tedavi seçeneğidir.Anah tar söz cük ler: İnen torasik aort; endovasküler; malperfüzyon; mortalite; rüptür. Background:This study aims to analyze early and midterm results of thoracic endovascular aortic repair performed in acute pathologies of descending aorta. Methods: Between September 2006 and April 2010, 25 patients (21 males, 4 females; mean age 62.1±14.8 years; range 26 to 82 years) with acute aortic syndrome who underwent emergent surgery in our clinic through endovascular approach were included in this study. Demographic characteristics, preoperative and postoperative data were analyzed retrospectively by means of file scanning method. Results: The procedure was successful in all patients. A total of 29 thoracic endograft were implanted in 25 patients. Three patients (12%) died before hospital discharge. Major complications of this procedure including neurologic event and type 1 endoleaks were not observed in any patient. The mean follow-up was 20.2±16.8 months. During this period, none of the patients had need procedure-related complications, while only one patient treated for penetrating atherosclerotic ulcer died at 20 months due to malignancy. Conclusion: Although our study was designed retrospectively with a small sample size, we detected low morbidity and mortality rates. These results are consistent with the literature, however further studies reflecting the long-term safety results are required. Thoracic endovascular aortic repair is a feasible option of treatment for acute pathologies of descending thoracic aorta.

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Endovascular Stent Grafting for Acute Thoracic Aortic Pathology

Abstract: Mortality and morbidity in our small series were low. Close follow-up is mandatory and long-term results have to be awaited.

Cited by 7 publications

References 31 publications

Thoracic endovascular aortic repair for acute complicated type B aortic dissection: Superiority relative to conventional open surgical and medical therapy

Thoracic endovascular aortic repair for acute complicated type B aortic dissection: Superiority relative to conventional open surgical and medical therapy

Biomechanical Changes After Thoracic Endovascular Aortic Repair in Type B Dissection

Thoracic endovascular aortic repair for acute pathologies of descending thoracic aorta

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