| Hybrid repair of aortic arch aneurysm. | |
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MedLine Citation:
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PMID: 17515267 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Conventional surgical repair of the aortic arch using cardiopulmonary bypass and deep hypothermic circulatory arrest still carries a substantial rate of mortality and morbidity especially myocardial injury, and predicts a high incidence of permanent neurological injury. Endovascular stent-graft placement has been developed as an effective treatment modality in various diseases of the descending aorta. Technological improvements nowadays allow deployment in the distal arch in most instances. However, in case of total involvement of the aortic arch endovascular SG repair, the challenge is to maintain blood flow to the brain and upper extremities, that may require covering one or more aortic branches in order to establish a secure proximal landing zone, and to ensure complete exclusion of the lesion. The aim of this study is to report our ongoing experience with endovascular treatment of aortic arch aneurysms. METHODS: During two years, 16 patients were treated with thoracic stent-grafts, after aortic arch debranching for repair of aortic arch aneurysm. All patients were at high risk for open repair and not candidates for standard endovascular repair due to inadequate proximal landing zones. Device design and implant strategy were on the basis of evaluation of aortic morphology with spiral CT. Stent grafts were inserted to repair the arch after supra-aortic vessel transposition was performed. Follow-up was 100% complete (mean 18 +/- 2.5 months, range 12-24 months). Follow-up included clinical examination, chest X-ray and computed tomography at discharge, 6 months after stent-graft placement and yearly thereafter. RESULTS: Primary technical success rate was 100%. Patency of all endografts and conventional bypasses was 100%. No endoleak or graft migration was observed. There were no neurological complications. Surgical conversion was never required. CONCLUSION: Hybrid aortic arch repair is technically challenging but feasible. This novel approach may be an alternative to standard open procedures in high-risk patients and emergency cases. However, the promising early results need to be confirmed by longer follow-up and larger series. |
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Authors:
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H M Saleh |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Acta chirurgica Belgica Volume: 107 ISSN: 0001-5458 ISO Abbreviation: Acta Chir. Belg. Publication Date: 2007 Mar-Apr |
Date Detail:
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Created Date: 2007-05-22 Completed Date: 2007-06-19 Revised Date: 2010-03-23 |
Medline Journal Info:
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Nlm Unique ID: 0370571 Medline TA: Acta Chir Belg Country: Belgium |
Other Details:
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Languages: eng Pagination: 173-80 Citation Subset: IM |
Affiliation:
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Ain Shams University Hospitals, Cairo, Egypt. hosamsaleh2003@yahoo.com |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Aged, 80 and over Aorta, Thoracic / radiography, surgery Aortic Aneurysm, Thoracic / radiography, surgery* Blood Vessel Prosthesis* Coronary Angiography Female Follow-Up Studies Humans Male Middle Aged Polyethylene Terephthalates Stents* Tomography, X-Ray Computed Treatment Outcome Vascular Patency |
| Chemical | |
Reg. No./Substance:
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0/Polyethylene Terephthalates |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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