Surgical treatment of intact thoracoabdominal aortic aneurysms in the United States: Hospital and surgeon volume-related outcomes

Cowan, John A.; Dimick, Justin B.; Henke, Peter K.; Huber, Thomas S.; Stanley, James C.; Upchurch, Gilbert R.

doi:10.1016/s0741-5214(03)00085-5

Cited by 362 publications

(256 citation statements)

References 18 publications

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“…Indeed, adequate staff support and hospital and surgeon volume significantly influence postoperative survival. Another study 234 clearly demonstrated that less experience correlated with increased post-operative mortality: in 1,542 operated patients, a significant difference (p < .001) in mortality was determined between low volume hospitals (27.4%) and high volume hospitals (15%). Also, low volume surgeons had significantly (p < .001) higher mortality rates (25.6%) compared with high volume surgeons (11.0%).…”

Section: Managementmentioning

confidence: 96%

Editor's Choice – Management of Descending Thoracic Aorta Diseases

Riambau¹,

Böckler²,

Brunkwall³

et al. 2017

European Journal of Vascular and Endovascular Surgery

915

259

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Section: Managementmentioning

confidence: 96%

Editor's Choice – Management of Descending Thoracic Aorta Diseases

Riambau¹,

Böckler²,

Brunkwall³

et al. 2017

European Journal of Vascular and Endovascular Surgery

915

259

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show abstract

“…Importantly, a recent study of surgical repair of thoracoabdominal aortic aneurysms found that surgical mortality was substantially higher in lowvolume hospitals and for low-volume surgeons compared with high-volume hospitals and high-volume surgeons. 28 An alternative approach for the repair of descending thoracic aneurysms is the use of a transluminally placed endovascular stent-graft ( Figure 10). This technique has the advantage of being far less invasive than surgery, with potentially fewer postoperative complications and lower morbidity.…”

Section: Descending Thoracic Aortic Aneurysmsmentioning

confidence: 99%

Thoracic and Abdominal Aortic Aneurysms

2005

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“…Morbidity and mortality rates vary according to the extent of the disease and the expertise of the surgeon. 3 Statewide audits provide a sobering picture of overall results, with 30-day mortality approaching 20%. 4 Minimally-invasive endovascular repair of TAAA has the potential to reduce mortality and morbidity.…”

Section: ¤ ¤mentioning

confidence: 99%

A Standardized Multi-Branched Thoracoabdominal Stent-Graft for Endovascular Aneurysm Repair

Sweet

Hiramoto

Park

et al. 2009

Journal of Endovascular Therapy

132

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¤ ¤Purpose: To assess the feasibility of endovascular thoracoabdominal aortic aneurysm (TAAA) repair using a standard off-the-shelf multi-branched stent-graft. Methods: The aortic anatomy of 66 patients (45 men; mean age 74 years, range 57-87) referred for endovascular repair of TAAA was measured using 3-dimensional reconstructed images from computed tomographic angiograms. In particular, the orientation and longitudinal position of the orifice of each celiac artery, right renal artery, and left renal artery were measured relative to the location of the superior mesenteric artery (SMA) orifice. Based on prior experience, branch insertion with a standard endograft was considered feasible under the following conditions: (1) no more than 4 indispensable (target) arteries to the abdominal viscera, (2) the celiac artery and SMA were 6 to 10 mm in diameter, (3) the renal arteries were 4 to 8 mm in diameter, (4) all target arteries were accessible from a transbrachial approach, (5) the distance between each cuff and the corresponding arterial orifice was #50 mm, and (6) the line between the cuff and the orifice deviated by #45u from the long axis of the aorta. Results: Seven (11%) of 66 patients violated conditions 1 through 4: 2 had target arteries that were either too wide or too narrow, 2 had .4 indispensable visceral or renal branches, and 3 patients had inaccessible upward directed renal artery branches. Three of the remaining 59 patients had renal arteries outside the boundaries defined by conditions 5 and 6 when the hypothetical stent-graft was positioned with its SMA cuff 25 mm proximal to the corresponding SMA orifice. However, if the stent-graft were deployed in a more caudal location, only 1 of these 3 renal arteries would have been out of range. Therefore, 58 (88%) of 66 patients met all the eligibility criteria for repair using the off-the-shelf stentgraft. Conclusion: A standardized, off-the-shelf, multi-branched stent-graft is applicable in 88% of cases of TAAA that would otherwise have been treated using customized stent-grafts. The use of a pre-made stent-graft has the potential to eliminate long manufacturing delays and expand the scope of endovascular repair of TAAA.

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Surgical treatment of intact thoracoabdominal aortic aneurysms in the United States: Hospital and surgeon volume-related outcomes

Cited by 362 publications

References 18 publications

Editor's Choice – Management of Descending Thoracic Aorta Diseases

Editor's Choice – Management of Descending Thoracic Aorta Diseases

Thoracic and Abdominal Aortic Aneurysms

A Standardized Multi-Branched Thoracoabdominal Stent-Graft for Endovascular Aneurysm Repair

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