Stroke From Thoracic Endovascular Procedures (STEP) Collaboration

Rohlffs, Fiona; Haulon, Stéphan; Kölbel, Tilo; Greenhalgh, Roger M.

doi:10.1016/j.ejvs.2019.12.037

Cited by 7 publications

(3 citation statements)

References 7 publications

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“…[29][30][31] These studies support the recommendation a more rigorous neuromonitoring and routine cerebral assessments, as proposed by the Stroke from Thoracic Endovascular Procedures collaboration. 32 Some technical points might explain the low rate of stroke in our study. First, the use of a preloaded catheter for the LSA branch might help to minimize the risk of embolization, which can occur with catheter manipulation or snaring across the aortic arch.…”

Section: Journal Of Vascular Surgerymentioning

confidence: 74%

Multicenter global early feasibility study to evaluate total endovascular arch repair using three-vessel inner branch stent-grafts for aneurysms and dissections

Tenorio

Oderich

Kölbel³

et al. 2021

Journal of Vascular Surgery

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Objective: We evaluated the outcomes of total endovascular aortic arch repair using three-vessel inner branch stentgrafts for aneurysms and chronic dissections.Methods: We reviewed the clinical data and outcomes of consecutive patients treated by total endovascular aortic arch repair at eight academic centers using three-vessel inner branch stent-grafts (William Cook Europe, Bjaeverskov, Denmark) from 2016 to 2019. All patients received three-vessel designs with two antegrade and one retrograde inner branch, which was used to incorporate the innominate, left common carotid, and left subclavian arteries. The antegrade inner branches were accessed via a carotid or an upper extremity approach. A preloaded catheter was used for access to the retrograde left subclavian artery branch via a transfemoral approach. The endpoints were technical success, mortality, major adverse events, any stroke (minor or major) or transient ischemia attack, secondary interventions, target vessel patency, target vessel instability, aneurysm-related mortality, and patient survival.Results: A total of 39 patients (31 men [79%]; mean age, 70 6 7 years) had undergone treatment of 14 degenerative (36%) and 25 chronic (64%) postdissection arch aneurysms. The clinical characteristics included American Society of Anesthesiologists class $III in 28 patients (95%) and previous median sternotomy for ascending aortic repair in 28 patients (72%). The technical success rate was 100%. Two patients had died in-hospital or within 30 days (5%), and two patients had experienced a stroke (one minor). The combined mortality and any stroke rate was 8% (n ¼ 3). Major adverse events occurred in 10 patients (26%), including respiratory failure in 4 (10%) and estimated blood loss >1 L, myocardial infarction, and acute kidney injury in 2 patients each (5%). The median follow-up was 3.2 months (interquartile range, 1-14 months). Of the 39 patients, 12 (31%) required secondary interventions to treat vascular access complications in 5, endoleak in 6 (three type II, one type Ic, one type Ia/Ib, one type IIIa), and target vessel stenosis in 1 patient. At 1 year, the primary and secondary patency rates and freedom from target vessel instability were 95% 6 5%, 100%, and 91% 6 5%, respectively. Freedom from aortic-related mortality and patient survival was 94% 6 4% and 90% 6 6%, respectively. Conclusions:The findings from the present multicenter global experience have demonstrated the technical feasibility and safety of total endovascular aortic arch repair for aneurysms and chronic dissections using three-vessel inner branch stent-grafts. The mortality and stroke rates compare favorably with those after open surgical repair in a higher risk group From the Department of cardiothoracic and vascular surgery, McGovern Med-

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Section: Journal Of Vascular Surgerymentioning

confidence: 74%

Multicenter global early feasibility study to evaluate total endovascular arch repair using three-vessel inner branch stent-grafts for aneurysms and dissections

Tenorio

Oderich

Kölbel³

et al. 2021

Journal of Vascular Surgery

Self Cite

View full text Add to dashboard Cite

show abstract

“…Initiated in 2017, the STEP registry represents a physician led group of 18 experienced operators in partnership with manufacturers of endovascular aortic arch devices, who intend to treat proximal aortic disease, and to provide best medical practice by consensus documents and prospective investigations to lower the risk of cerebrovascular events. 18 The current study is the first generated from this expert platform.…”

Section: Discussionmentioning

confidence: 99%

“…The purpose of this work was to quantify SBI in a patient population that underwent advanced endovascular aortic arch treatment using the STEP registry (NCT04489277). 18 This study includes total endovascular arch repairs, and CO 2 flushed devices as an embolic protection strategy.…”

Section: Introductionmentioning

confidence: 99%