Document Detail

Endovascular treatment of aortic arch aneurysms.
MedLine Citation:
PMID:  15649718     Owner:  NLM     Status:  MEDLINE    
INTRODUCTION: The aim of this study was to review our clinical experience with endovascular treatment of aortic arch aneurysms using different commercially available grafts (Gore, Talent, Endomed, Cook). METHODS: From 1999 to 2004, 97 patients received endovascular treatment for diseases of the thoracic aorta. In 30 cases (26 males, 4 females) the aortic arch was involved. The left subclavian artery was overstented (Ishimaru zone '2') in 18 cases (60%). Only in the first three cases had the subclavian artery been revascularized. The left common and subclavian arteries were covered (zone '1') in 6 (20%) cases-all had the carotid artery reconstructed, either simultaneously (five cases) or as a staged procedure (one case). Finally, the whole aortic arch was over-stented (zone '0') in 6 (20%) cases, with simultaneous (five cases) or staged (one case) grafting of the supra-aortic vessels from the ascending aorta. RESULTS: Perioperative mortality was 2/30 (7%), due to graft migration (zone '2') and intra-operative stroke (zone '0'), respectively. One minor stroke was observed. No cases of paraplegia were recorded. Three type I endoleaks were observed. Two resolved at 6 months follow-up; one zone '0' graft is still being followed. There was one surgical conversion for endograft failure 2 weeks after implantation. Thus, the technical success rate was 87% (26/30) cases. The mean follow-up time was 23+/-17 months. No new onset endoleaks or aneurysm-related deaths were recorded. CONCLUSIONS: Currently available grafts may be deployed in the aortic arch in most instances. De-branching of the aortic arch with surgical revascularization for zone '0' and '1' seems to be adequate to obtain a satisfactory proximal landing zone.
G Melissano; E Civilini; L Bertoglio; F Setacci; R Chiesa
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery     Volume:  29     ISSN:  1078-5884     ISO Abbreviation:  Eur J Vasc Endovasc Surg     Publication Date:  2005 Feb 
Date Detail:
Created Date:  2005-01-14     Completed Date:  2005-03-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9512728     Medline TA:  Eur J Vasc Endovasc Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  131-8     Citation Subset:  IM    
Department of Vascular Surgery, Vita-Salute University, Scientific Institute H. San Raffaele, Milan, Italy.
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MeSH Terms
Aged, 80 and over
Aortic Aneurysm, Thoracic / surgery*
Blood Vessel Prosthesis*
Blood Vessel Prosthesis Implantation / methods*
Equipment Design
Intraoperative Complications
Middle Aged
Subclavian Artery / surgery*
Treatment Outcome
Reg. No./Substance:

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