Results From a Nationwide Registry on Scalloped Thoracic Stent-Grafts for Short Landing Zones

Weijde, Emma van der; Bakker, Olaf J.; Tielliu, Ignace F.J.; Zeebregts, Clark J.; Heijmen, Robin H.

doi:10.1177/1526602816674942

Cited by 21 publications

(18 citation statements)

References 44 publications

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“…Current guidelines for endovascular repair typically recommended a 2 cm length for the proximal landing zone. 16 The anatomic challenging made it difficult to obtain seal and fixation within the proximal landing zone. [17][18][19] Besides, the hemodynamic forces in the ascending aorta were excessive, leading to variations in diameter of the normal ascending aorta by at least 8%.…”

Section: Discussionmentioning

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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Section: Discussionmentioning

confidence: 99%

Systematic review of endovascular repair of ascending aortic dissection

Zhang

et al. 2019

Cathet Cardio Intervent

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“…The use of one proximal or distal scallop for multiple adjacent vessels has been reported previously. 25,37 The distal extent of the dissection was out of the scope of this feasibility study. Since the goal in TEVAR for type B aortic dissection is to seal the proximal intimal entry tear, the majority of centers today use a 20-cm-long proximal stent-graft that will land distally in the straight segment of the descending thoracic aorta.…”

Section: Discussionmentioning

confidence: 99%

“…In accord with the required sizing for scalloped TEVAR in degenerative aneurysms, 23,25 an additional 2 mm were added to the measured width of the LSA ostium to determine the required safe width of the scallop. The maximum length of the scallop was determined by adding the distance between the LSA and LCCA to the measured length of the LSA ostium.…”

Section: Methodsmentioning

confidence: 99%

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A Feasibility Study of Off-the-Shelf Scalloped Stent-Grafts in Acute Type B Aortic Dissection

et al. 2017

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In this single-center imaging-based study, involvement of the LSA in the setting of acute type B aortic dissection was seen in 80% of patients treated with TEVAR. Three off-the-shelf stent-grafts would suffice to treat one-third of these acute type B aortic dissections and may offer a relatively simple solution to preserve LSA flow, thereby lowering the risk of malperfusion of the (posterior) cerebrum, spinal cord, and left arm in an urgent/emergent setting.

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“…Most commonly the scallop is used to preserve the LSCA, although scallops for the LCCA and innominate artery have also been placed successfully, and this technology may be combined with a custom-made fenestration to preserve multiple trunks. Few series have been published; however, early and mid-term outcomes appear acceptable, with very low rates of endoleak and stroke, and no reports of retrograde dissection 51,59,60 .…”

Section: Total Endovascular Arch Repairmentioning

confidence: 99%