Document Detail


Fenestrated and branched endografts for the treatment of thoracoabdominal aortic aneurysms: a systematic review.
MedLine Citation:
PMID:  20426638     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To offer a critical review of the current literature on the use of fenestrated and branched stent-grafts in patients with thoracoabdominal aortic aneurysms (TAAA). METHODS: A thorough search of the English-language literature published between January 2000 and September 2009 identified reports of endovascular procedures using fenestrated and/or branched endografts as the intended repair strategy in patients with TAAA. Studies were selected based on specific inclusion criteria: (1) >3 high-risk patients with preoperative diagnosis of TAAA, (2) the intended treatment strategy was an endovascular repair using a fenestrated or branched endograft or both, and (3) patient demographics and outcome data (technical success rate, 30-day mortality, and follow-up length) were clearly stated. From 47 articles initially identified, 7 studies were included in the statistical analysis encompassing 155 patients (mean age 74.4 years, range 41-86) with TAAA averaging 69.2 mm in diameter. The mean follow-up was 11.8 months, and the majority of patients had Crawford type IV aneurysms. Outcome measures of eligible studies were tabulated and then analyzed cumulatively. RESULTS: Technical success was achieved in 94.2% (n = 146) of the 155 patients. Twenty-three (18.4%) primary endoleaks were reported. The 30-day mortality was 7.1% (n = 11), while the 1-year survival rate was 82.6% (n = 128). Three (1.9%) patients developed permanent paraplegia and 2 (1.3%) developed permanent paraparesis; renal failure was reported in 9 (5.8%). Overall follow-up mortality was 16.1% (n = 25). CONCLUSION: Endovascular treatment with fenestrated or/and branched stent-grafts is a new therapeutic option with encouraging results for patients considered unfit for conventional open repair. However, prolonged follow-up studies are needed in order to draw robust conclusions.
Authors:
Chris N Bakoyiannis; Konstantinos P Economopoulos; Sotirios Georgopoulos; Chris Klonaris; Maria Shialarou; Marina Kafeza; Efstathios Papalambros
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists     Volume:  17     ISSN:  1545-1550     ISO Abbreviation:  J. Endovasc. Ther.     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-04-29     Completed Date:  2010-08-12     Revised Date:  2010-10-20    
Medline Journal Info:
Nlm Unique ID:  100896915     Medline TA:  J Endovasc Ther     Country:  United States    
Other Details:
Languages:  eng     Pagination:  201-9     Citation Subset:  IM    
Affiliation:
First Department of Surgery, Vascular Department, University of Athens, "Laiko" General Hospital, Athens, Greece.
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MeSH Terms
Descriptor/Qualifier:
Angioplasty*
Aortic Aneurysm, Thoracic / etiology,  pathology,  therapy*
Blood Vessel Prosthesis*
Blood Vessel Prosthesis Implantation*
Humans
Patient Selection
Prosthesis Design
Prosthesis Fitting
Stents*
Treatment Outcome
Comments/Corrections
Comment In:
J Endovasc Ther. 2010 Apr;17(2):212-5   [PMID:  20426640 ]
J Endovasc Ther. 2010 Oct;17(5):673-4; author reply 674-5   [PMID:  20939730 ]
J Endovasc Ther. 2010 Apr;17(2):210-1   [PMID:  20426639 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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