| Hybrid aortic arch repair procedure: reinforcement of the aorta for a safe and durable landing zone. | |
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MedLine Citation:
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PMID: 20870433 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: Hybrid aortic arch repair procedure was introduced to reduce invasiveness in high-risk patients with aortic arch pathology. The good results are expanding its application, but endoleak, particularly type I, remains its Achilles' heel. DESIGN: We describe our experience with hybrid treatment of aortic arch diseases focussing on techniques and results to avoid type I endoleak. MATERIALS AND METHODS: A total of 15 high-risk patients with zone 0-2 aortic arch pathology underwent supra-aortic debranching on ascending aorta and proximal aortic arch reinforcement with a Dacron prosthesis. Metachronously, the procedure was completed with endovascular stent grafting (ESG). RESULTS: Median age was 70 years with a mean European System for Cardiac Operative Risk Evaluation (EuroSCORE) of 12.7±6.8. One patient died between aortic debranching and ESG. Mean time between surgical debranching and ESG was 32±27.7 days. No major neurological events occurred. Mean length of the landing zone for ESG was 3.8±0.8 cm. Computed tomography (CT) angiography scan performed soon after operation, and at 3, 6, and 12 months did not show any type I endoleak. CONCLUSIONS: Supra-aortic debranching on ascending aorta with proximal aortic arch reinforcement is a useful step to ensure a safe landing zone for ESG, reducing risk early to midterm of endoleak. Longer term follow-up is required to confirm the viability of this technique. |
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Authors:
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G Gelpi; P Vanelli; A Mangini; P Danna; M Contino; C Antona |
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Publication Detail:
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Type: Journal Article Date: 2010-09-25 |
Journal Detail:
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Title: European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery Volume: 40 ISSN: 1532-2165 ISO Abbreviation: Eur J Vasc Endovasc Surg Publication Date: 2010 Dec |
Date Detail:
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Created Date: 2010-11-29 Completed Date: 2011-01-07 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9512728 Medline TA: Eur J Vasc Endovasc Surg Country: England |
Other Details:
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Languages: eng Pagination: 709-14 Citation Subset: IM |
Copyright Information:
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Copyright © 2010 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved. |
Affiliation:
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Cardiovascular Surgery Division of L. Sacco Hospital, University of Milan, Via GB Grassi 74, 20175 Milan, Italy. gelpi.guido@hsacco.it |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Aorta, Thoracic / radiography, surgery* Aortic Diseases / mortality, radiography, surgery* Aortography / methods Blood Vessel Prosthesis Blood Vessel Prosthesis Implantation / adverse effects, instrumentation, methods*, mortality Endoleak / etiology, prevention & control Endovascular Procedures* / adverse effects, instrumentation, mortality Female Humans Italy Kaplan-Meier Estimate Male Middle Aged Polyethylene Terephthalates Prosthesis Design Retrospective Studies Stents Time Factors Tomography, X-Ray Computed Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Polyethylene Terephthalates |
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