Hybrid aortic repair in patients with type III aortic dissection and concomitant proximal aortic lesion

Charchyan, E. R.; Breshenkov, D.G.; Belov, Yu. V.

doi:10.17116/hirurgia202009128

Cited by 7 publications

(11 citation statements)

References 30 publications

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“…The mean follow up time was 16 months and 14.5 months respectively for group one and two. This study contradicts Kreibich et al ( 9 ) study, as it provides a direct comparison between devices and confirms Thoraflex Hybrid™ superiority over E-Vita ( 32 ). Only one study looking at E-Vita Open device reported a relatively low dSINE occurrence of 1% of a patient population of 286.…”

Section: Distal Stent Induced New Entrycontrasting

confidence: 80%

“…Terumo Aortic's Thoraflex TM Hybrid is an excellent FET device with very favorable survival outcomes that are to some extent superior to those offered by other commercially available devices. The incidence of dSINE with Thoraflex Hybrid TM can be considered the lowest within the aortic arch prostheses market as demonstrated above (9,20,24,25,(31)(32)(33)(34)(35)(36)(37).…”

Section: Distal Stent Induced New Entrymentioning

confidence: 96%

“…For example, the incidence of dSINE reported in the studies identified ranged from 0 to 14.5% with Thoraflex Hybrid TM , 1-18.2% with E-Vita, and 0-27.3% with Frozenix TM . The size and length of device used are interconnected with the incidence of dSINE (9,20,24,25,(31)(32)(33)(34)(35)(36)(37). A summary of all the dSINE findings to-be discussed in this section can be found in Table 5.…”

Section: Distal Stent Induced New Entrymentioning

confidence: 99%

“…Charchyan et al ( 32 ) compared the rate of dSINE in different operative stent devices. Group one was treated with distal Z shaped nitinol stent grafts (E-Vita), group two was treated with ring shaped nitinol stent graft (Thoraflex™ Hybrid) and group three used distal dissection-specific stent grafts (Valiant™ retrograde stent graft, Medtronic Vascular, Santa Rosa, CA, USA).…”

Section: Distal Stent Induced New Entrymentioning

confidence: 99%

“…This study is helpful as it provides significant evidence supporting the numerical trends suggested by Kreibich et al ( 9 ). Charchyan et al ( 32 ) also suggested using a dissection specific stent graft with a tapered structure thus preventing oversizing at the distal edge or using a longer stent graft to minise the occurrence of dSINE.…”

Section: Distal Stent Induced New Entrymentioning

confidence: 99%

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Incidence of Distal Stent Graft Induced New Entry vs. Aortic Remodeling Associated With Frozen Elephant Trunk

Jubouri

Kayali

Saha

et al. 2022

Front. Cardiovasc. Med.

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BackgroundThe introduction of the frozen elephant trunk (FET) technique for total arch replacement (TAR) has revolutionized the field of aortivascular surgery by allowing hybrid repair of complex aortic pathologies in a single step through combining an open surgical approach with an endovascular one. FET has been associated with favorable aortic remodeling, however, its is also associated with development of distal stent graft induced new entry (dSINE) tears postoperatively. The rate of aortic remodeling and the incidence of dSINE have been linked together, in addition, there seems to be a relationship between these two variables and FET insetion length as well as graft size.AimsThe scope of this review is to highlight the rate of aortic remodeling as well the incidence of dSINE associated with different FET devices available commercially. This review also aimed to investigate the relationship between aortic remodeling, dSINE, FET insertion length and FET graft size.MethodsWe conducted a comprehensive literature search using multiple electronic databases including PubMed, Ovid, Scopus and Embase in order to collate all research evidence on the above mentioned variables.ResultsThoraflex™ Hybrid Plexus seems to yield optimum aortic remodeling by promoting maximum false thrombosis as well true lumen expansion. Thoraflex Hybrid™ is also associated with the lowest incidence of dSINE post-FET relative to the other FET devices on the market. Aortic remodeling and dSINE do influence each other and are both linked with FET graft length and size.ConclusionThe FET technique for TAR shows excellent aortic remodeling but is associated with a considerable risk of dSINE development. However, Thoraflex™ Hybrid has demonstrated itself to be the superior FET device on the aortic arch prostheses market. Since aortic remodeling, dSINE, FET insertion length and stent graft size are all interconnect, the choice of FET device length and size must be made with great care for optimum results.

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Section: Distal Stent Induced New Entrycontrasting

confidence: 80%

Section: Distal Stent Induced New Entrymentioning

confidence: 96%

Section: Distal Stent Induced New Entrymentioning

confidence: 99%

Section: Distal Stent Induced New Entrymentioning

confidence: 99%

Section: Distal Stent Induced New Entrymentioning

confidence: 99%

See 3 more Smart Citations

Incidence of Distal Stent Graft Induced New Entry vs. Aortic Remodeling Associated With Frozen Elephant Trunk

Jubouri

Kayali

Saha

et al. 2022

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

show abstract

Aortic remodeling, distal stent‐graft induced new entry and endoleak following frozen elephant trunk: A systematic review and meta‐analysis

Nakhaei

Bashir

Jubouri

et al. 2022

Journal of Cardiac Surgery

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Background The introduction of the frozen elephant trunk (FET) technique for total arch replacement (TAR) has revolutionized the field of aortovascular surgery. However, although FET yields excellent results, the risk of certain complications requiring secondary intervention remains present, negating its one‐step hybrid advantage over conventional techniques. This systematic review and meta‐analysis sought to evaluate controversies regarding the incidence of FET‐related complications, with a focus on aortic remodeling, distal stent‐graft induced new entry (dSINE) and endoleak, in patients with type A aortic dissection (TAAD) and/or thoracic aortic aneurysm. Materials and Methods A comprehensive literature search was conducted using multiple electronic databases including EMBASE, Scopus, and PubMed/MEDLINE to identify evidence on TAR with FET in patients with TAAD and/or aneurysm. Studies published up until January 2022 were included, and after applying exclusion criteria, a total of 43 studies were extracted. Results A total of 5068 patients who underwent FET procedure were included. The pooled estimates of dSINE and endoleak were 2% (95% confidence interval [CI] 0.01–0.06, I2 = 78%) and 3% (95% CI 0.01–0.11, I2 = 89%), respectively. The pooled rate of secondary thoracic endovascular aortic repair (TEVAR) post‐FET was 7% (95% CI 0.05–0.12, I2 = 89%) while the pooled rate of false lumen thrombosis at the level of stent‐graft was 91% (95% CI 0.75–0.97, I2 = 92%). After subgroup analysis, heterogeneity for distal stent‐graft induced new entry (dSINE) and endoleak resolved among European patients, where Thoraflex Hybrid (THP) and E‐Vita stent‐grafts were used (both I2 = 0%). In addition, heterogeneity for secondary TEVAR after FET resolved among Asians receiving Cronus (I2 = 15.1%) and Frozenix stent‐grafts (I2 = 1%). Conclusion Our results showed that the FET procedure in patients with TAAD and/or aneurysm is associated with excellent results, with a particularly low incidence of dSINE and endoleak as well as highly favorable aortic remodeling. However the type of stent‐graft and the study location were sources of heterogeneity, emphasizing the need for multicenter studies directly comparing FET grafts. Finally, THP can be considered the primary FET device choice due to its superior results.

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Hybrid revascularization in a patient with Covid-19 and chronic limb ischemia stage IV

Chernyavsky¹,

Susanin²,

Soloviev³

et al. 2022

Khir. Z. im. N.I. Pirogova

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Hybrid aortic repair in patients with type III aortic dissection and concomitant proximal aortic lesion

Cited by 7 publications

References 30 publications

Incidence of Distal Stent Graft Induced New Entry vs. Aortic Remodeling Associated With Frozen Elephant Trunk

Incidence of Distal Stent Graft Induced New Entry vs. Aortic Remodeling Associated With Frozen Elephant Trunk

Aortic remodeling, distal stent‐graft induced new entry and endoleak following frozen elephant trunk: A systematic review and meta‐analysis

Hybrid revascularization in a patient with Covid-19 and chronic limb ischemia stage IV

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