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Wartman SM, Woo K, Brewer M, Weaver FA. Management of a Large Abdominal Aortic Aneurysm in Conjunction with a Massive Inguinal Hernia. Ann Vasc Surg 2017; 42:302.e7-302.e10. [PMID: 28389284 DOI: 10.1016/j.avsg.2017.03.166] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Revised: 03/08/2017] [Accepted: 03/26/2017] [Indexed: 11/28/2022]
Abstract
The majority of inguinal hernias that are concomitant with abdominal aortic aneurysms (AAAs) are clinically insignificant. However, management of AAA associated with a complex hernia can be challenging. We report a case of a 72-year-old male with a 7-cm AAA and a massive inguinal hernia involving loss of abdominal domain. Using a multidisciplinary approach, a staged hybrid endovascular and open repair of the AAA was performed followed by hernia repair.
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Affiliation(s)
- Sarah M Wartman
- Division of Vascular Surgery and Endovascular Therapy, Keck Medical Center of USC, University of Southern California, Los Angeles, CA.
| | - Karen Woo
- Division of Vascular Surgery and Endovascular Therapy, Keck Medical Center of USC, University of Southern California, Los Angeles, CA
| | - Michael Brewer
- Division of Vascular Surgery and Endovascular Therapy, Keck Medical Center of USC, University of Southern California, Los Angeles, CA
| | - Fred A Weaver
- Division of Vascular Surgery and Endovascular Therapy, Keck Medical Center of USC, University of Southern California, Los Angeles, CA.
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Endovascular treatment of synchronous and metachronous aneurysms of the thoracic aorta. Is there an increase in the procedural risk? ANGIOLOGIA E CIRURGIA VASCULAR 2016. [DOI: 10.1016/j.ancv.2016.04.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Belov YV, Komarov RN, Karavaykin PA. Cardiovascular surgeon’s role in hybrid aortic surgery (part 2). ACTA ACUST UNITED AC 2016. [DOI: 10.17116/kardio20169134-41] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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4
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Tshomba Y, Mascia D, Kahlberg A, Marone E, Melissano G, Chiesa R. On-label Use of Commercially-available Abdominal Endografts for Para-anastomotic Aneurysms and Pseudoaneurysms After Infrarenal Abdominal Aortic Aneurysm Open Repair. Eur J Vasc Endovasc Surg 2013; 46:657-66. [DOI: 10.1016/j.ejvs.2013.09.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2013] [Accepted: 09/12/2013] [Indexed: 10/26/2022]
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Liu Z, Zhou M, Liu C, Qiao T, Huang D, Zhang M, Ran F, Wang W, Liu C. Hybrid procedures for thoracoabdominal aortic pathologies. Vascular 2013; 21:205-14. [PMID: 23518841 DOI: 10.1177/1708538113478772] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We report our three-year experience with the visceral hybrid procedure for patients with thoracoabdominal aortic aneurysms, dissections and Takayasu's arteritis. We also evaluate and discuss the outcomes of hybrid procedures. Hybrid procedures include debranching of the visceral or renal arteries followed by endovascular repair of the disease. The surgical strategy was designed individually to reduce trauma and minimize stent coverage area. A series of 11 patients (9 men, mean age 52 years) were treated between June 2008 and September 2011. The pathologies were aneurysmal disease (thoracoabdominal aortic aneurysms) (5, 45.5%), aortic dissection (thoracoabdominal aortic dissection) (4, 36.4%) or true/false aneurysm formation after Takayasu's arteritis (2, 18.2%). Simultaneous approach (9, 81.8%) and staged approach (2, 18.2%) were performed. The mean follow-up was 13.5 months (range 1–36). The technical success was 100%. Stent grafts were implanted in the entire or part of the thoracoabdominal aorta. The overall mortality rate was 9.1% (1/11) with no aneurysm-related death. The permanent paraplegia and bypass graft occlusion rate was 0%. The overall morbidity was 36.4% with two endoleaks (2/11, 18.2%). In conclusion, hybrid procedures can minimize surgical invasiveness in treatments of thoracoabdominal aortic pathologies, and it is a safe method with acceptable morbidity and mortality.
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Affiliation(s)
- Zhao Liu
- Department of Vascular Surgery, The Affiliated Drum Tower Hospital, Nanjing University Medical School, Nanjing 210008, China
| | - Min Zhou
- Department of Vascular Surgery, The Affiliated Drum Tower Hospital, Nanjing University Medical School, Nanjing 210008, China
| | - Chen Liu
- Department of Vascular Surgery, The Affiliated Drum Tower Hospital, Nanjing University Medical School, Nanjing 210008, China
| | - Tong Qiao
- Department of Vascular Surgery, The Affiliated Drum Tower Hospital, Nanjing University Medical School, Nanjing 210008, China
| | - Dian Huang
- Department of Vascular Surgery, The Affiliated Drum Tower Hospital, Nanjing University Medical School, Nanjing 210008, China
| | - Ming Zhang
- Department of Vascular Surgery, The Affiliated Drum Tower Hospital, Nanjing University Medical School, Nanjing 210008, China
| | - Feng Ran
- Department of Vascular Surgery, The Affiliated Drum Tower Hospital, Nanjing University Medical School, Nanjing 210008, China
| | - Wei Wang
- Department of Vascular Surgery, The Affiliated Drum Tower Hospital, Nanjing University Medical School, Nanjing 210008, China
| | - Changjian Liu
- Department of Vascular Surgery, The Affiliated Drum Tower Hospital, Nanjing University Medical School, Nanjing 210008, China
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Janczak D, Garcarek J, Bogdanik R, Szydelko T, Chabowski M, Wojtanowski M. Eight-year follow-up of a high-risk patient treated for Crawford Type II thoracoabdominal aortic aneurysm (TAAA) with a multistage hybrid open-endovascular repair. Ann Thorac Cardiovasc Surg 2012; 19:166-9. [PMID: 22971708 DOI: 10.5761/atcs.cr.12.01924] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The case of a patient with type II TAAA (thoracoabdominal aortic aneurysm), who underwent multistage hybrid procedure, is presented. This high-risk patient was excluded as ineligible for conventional open repair. At first, the bypass between both common carotid arteries was inserted. Then, the transperitoneal viscerorenal revascularization was performed to ensure blood perfusion. At the end, the stent graft from the aorta arch to its bifurcation was deployed with endovascular techniques. This stent graft covered left common carotid artery, left subclavian artery, visceral trunk, superior mesenteric artery and both renal arteries. The patient had been observed for eight years with relatively low complication rate. The hybrid open-endovascular repair (HOER) shows promising results in patients at prohibitive risk for classic reconstruction.
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Affiliation(s)
- Dariusz Janczak
- Department of Clinical Proceedings, Faculty of Health Science, Medical University Wroclaw, 5 Weigla Street, Wroclaw, Poland
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Management of Perioperative Endoleaks During Endovascular Treatment of Juxta-Renal Aneurysms. Ann Vasc Surg 2012; 26:175-84. [DOI: 10.1016/j.avsg.2010.10.021] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2010] [Revised: 09/26/2010] [Accepted: 10/25/2010] [Indexed: 11/17/2022]
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8
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Ham SW, Chong T, Moos J, Rowe VL, Cohen RG, Cunningham MJ, Wilcox A, Weaver FA. Arch and visceral/renal debranching combined with endovascular repair for thoracic and thoracoabdominal aortic aneurysms. J Vasc Surg 2011; 54:30-40; discussion 40-1. [DOI: 10.1016/j.jvs.2010.12.033] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2010] [Revised: 12/06/2010] [Accepted: 12/06/2010] [Indexed: 10/18/2022]
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Endovascular and Open Surgical Treatment of Brachiocephalic Arteries. Ann Vasc Surg 2011; 25:569-81. [DOI: 10.1016/j.avsg.2010.10.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2010] [Revised: 10/15/2010] [Accepted: 10/17/2010] [Indexed: 11/19/2022]
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Yeung KK, Tangelder GJ, Fung WY, Coveliers HME, Hoksbergen AWJ, Van Leeuwen PAM, de Lange-de Klerk ESM, Wisselink W. Open surgical repair of ruptured juxtarenal aortic aneurysms with and without renal cooling: observations regarding morbidity and mortality. J Vasc Surg 2010; 51:551-8. [PMID: 20100646 DOI: 10.1016/j.jvs.2009.09.051] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2009] [Revised: 09/23/2009] [Accepted: 09/27/2009] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Little is known about the outcome of ruptured juxtarenal aortic aneurysm (RJAA) repair. Surgical treatment of RJAAs requires suprarenal aortic cross-clamping, which causes additional renal ischemia-reperfusion injury on top of the pre-existing hypovolemic shock syndrome. As endovascular alternatives rarely exist in this situation, open repair continues to be the gold standard. We analyzed our results of open RJAA repair during an 11-year period. DESIGN Retrospective observational study. MATERIALS AND METHODS Between July 1997 and December 2008, all consecutive patients with RJAAs were included in the study. Part of these patients received cold perfusion of the kidneys during suprarenal aortic cross-clamping. Perioperative variables, morbidity, and 30-day or in-hospital mortality were assessed. Renal insufficiency was defined as an acute rise of >or=0.5 mg/dL in serum creatinine level. Multiple organ failure (MOF) was scored using the sequential organ failure assessment score (SOFA score). RESULTS A total of 29 consecutive patients with an RJAA, confirmed by computed tomography-scanning, presented to our hospital. In eight patients, the operation was aborted before the start of aortic repair, because no blood pressure could be regained in spite of maximal resuscitation measures. They were excluded from further analysis. Of the remaining 21 patients, 10 died during hospital stay. Renal insufficiency occurred in 11 out of 21 of the patients. Eleven out of 21 patients developed MOF postoperatively. In a subgroup of patients who received renal cooling during suprarenal aortic clamping, the 30-day or in-hospital mortality was two of 10 vs eight of 11 in patients who did not receive renal cooling (P = .03); renal insufficiency occurred in one out of 10 patients in the subgroup with renal cooling vs 10 out of 11 without renal cooling (P < .001) and MOF in two of 10 vs nine of 11, respectively (P = .009). CONCLUSIONS Open surgical repair of RJAAs is still associated with high mortality and morbidity. To our knowledge, this is the first report of cold perfusion of the kidneys during RJAA repair. Although numbers are small, a beneficial effect of renal cooling on the outcome of RJAA repair is suggested, warranting further research with this technique.
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Affiliation(s)
- Kak K Yeung
- Department of Surgery, VU University Medical Center Amsterdam, Amsterdam, The Netherlands
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Hybrid repair of complex thoracoabdominal aortic aneurysms using applied endovascular strategies combined with visceral and renal revascularization. J Thorac Cardiovasc Surg 2009; 138:1331-8. [DOI: 10.1016/j.jtcvs.2009.03.032] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2008] [Revised: 12/03/2008] [Accepted: 03/21/2009] [Indexed: 11/18/2022]
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Bakoyiannis C, Kalles V, Economopoulos K, Georgopoulos S, Tsigris C, Papalambros E. Hybrid Procedures in the Treatment of Thoracoabdominal Aortic Aneurysms:. J Endovasc Ther 2009; 16:443-50. [DOI: 10.1583/1545-1550-16.4.443] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Joels CS, Langan EM, Daley CA, Kalbaugh CA, Cass AL, Cull DL, Taylor SM. Changing Indications and Outcomes for Open Abdominal Aortic Aneurysm Repair since the Advent of Endovascular Repair. Am Surg 2009. [DOI: 10.1177/000313480907500806] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The indications for open abdominal aortic aneurysm (AAA) repair have changed with the development of endovascular techniques. The purpose of this study is to clarify the indications and outcomes for open repair since endovascular aneurysm repair (EVAR) and to compare contemporary AAA repair with the pre-EVAR era. Patients undergoing open AAA repair were identified; the demographics, outcomes, and indications for open repair were reviewed. Outcomes were compared based on indication for open repair in the EVAR era and between the pre-EVAR and EVAR eras. Open indications in the EVAR era included: age younger than 65 years with minimal comorbidities (AGE, n = 24 [9.8%]), unfavorable anatomy (ANAT, n = 146 [59.3%]), aortoiliac occlusive disease (AIOD, n = 38 [15.4%]), and miscellaneous (OTHER, n = 38 [15.4%]). Mortality (30-day and 5-year) was affected by indication: AGE = 0 and 0 per cent, ANAT = 4.1 and 49.7 per cent, AIOD = 13.5 and 32.3 per cent, and OTHER = 5.3 and 41.8 per cent. Age, sex, race, coronary artery disease, and peripheral artery disease were similar between the pre-EVAR and EVAR eras. EVAR-era patients had more diabetes mellitus, hypertension, and hyperlipidemia and longer operative time. Mortality was not different, but complication rates were lower in the pre-EVAR era (23.7 vs 43.5%, P = 0.025). Patients undergoing open AAA repair in the EVAR era have more comorbidities, longer operative times, and more complications. Outcomes for EVAR-era patients are affected by the indication for open repair. A preference for open repair in younger patients with minimal comorbidities is justified.
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Affiliation(s)
- Charles S. Joels
- Academic Department of Surgery, Greenville Hospital System University Medical Center, Greenville, South Carolina
| | - Eugene M. Langan
- Academic Department of Surgery, Greenville Hospital System University Medical Center, Greenville, South Carolina
| | - Charles A Daley
- Academic Department of Surgery, Greenville Hospital System University Medical Center, Greenville, South Carolina
| | - Corey A. Kalbaugh
- Academic Department of Surgery, Greenville Hospital System University Medical Center, Greenville, South Carolina
| | - Anna L. Cass
- Academic Department of Surgery, Greenville Hospital System University Medical Center, Greenville, South Carolina
| | - David L. Cull
- Academic Department of Surgery, Greenville Hospital System University Medical Center, Greenville, South Carolina
| | - Spence M. Taylor
- Academic Department of Surgery, Greenville Hospital System University Medical Center, Greenville, South Carolina
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Aguiar Lucas L, Rodriguez-Lopez JA, Olsen DM, Diethrich EB. Endovascular repair in the thoracic and abdominal aorta: no increased risk of spinal cord ischemia when both territories are treated. J Endovasc Ther 2009; 16:189-96. [PMID: 19456189 DOI: 10.1583/08-2506.1] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE To evaluate the morbidity associated with thoracic and abdominal aortic repair using endovascular exclusion alone or combined endovascular and open repair. METHODS Between January 1998 and February 2007, 49 patients (36 men; mean age 70 years) underwent treatment for thoracic and abdominal aorta disease with descending thoracic aortic (DTA) stent-graft and abdominal aortic repair. Thirty-nine patients with coexisting thoracic and abdominal pathologies were classified with multilevel aortic disease (MLAD), whereas 10 patients presented with thoracoabdominal aneurysm. Patients were separated into 3 groups: 1: thoracic stent-grafts and open abdominal repair (n = 18), group 2: thoracic and abdominal stent-grafts (n = 21), and group 3: thoracic stent-grafts with visceral artery debranching (n = 10). Prior carotid-subclavian bypass was performed in 3 (6%) patients with a dominant left vertebral artery. RESULTS Stent-graft deployment was technically successful in all cases. Eight (16%) patients underwent emergent thoracic stent-graft placement. In 9 (18%) patients, the left subclavian artery was covered. No incidence of spinal cord ischemia was observed. The 30-day mortality was 4%, and overall mortality was 6% over a mean 33-month follow-up. The endoleak rate was 6% (1 type I, 1 type II, and 1 type III). CONCLUSION Conventional or endovascular abdominal open repair in combination with DTA stent-grafting is feasible and a safe alternative to traditional open repair. Management of MLAD did not show increased incidence of spinal cord ischemia and was associated with fewer complications and deaths than simultaneous or staged open thoracic and abdominal repairs.
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Affiliation(s)
- Leonardo Aguiar Lucas
- Department of Cardiovascular and Endovascular Surgery, Arizona Heart Institute and Hospital, Phoenix, Arizona, USA
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Di Centa I, Coggia M, Cochennec F, Javerliat I, Alfonsi P, Goëau-Brissonniere O. Total laparoscopic repair of abdominal aortic aneurysm with short proximal necks. Ann Vasc Surg 2009; 23:43-8. [PMID: 19135910 DOI: 10.1016/j.avsg.2008.09.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2008] [Accepted: 09/13/2008] [Indexed: 11/27/2022]
Abstract
With the development of endovascular aneurysm repair, abdominal aortic aneurysms with short infrarenal necks (< or =10 mm, AAASN) are considered juxtarenal aneurysms. Minimally invasive treatment consists of hybrid procedures or fenestrated endografts. We present our experience with direct aortic repair for AAASN performed via a total laparoscopic approach. Data are expressed as median values with extremes. From February 2002 to December 2007, 32 patients had total laparoscopic AAASN repair. Length of the infrarenal aortic neck was 5 mm (0-10). Median age of the 29 men and three women was 70 years (range 50-84). Nine patients presented with preoperative grade 1 renal insufficiency (28.1%). The procedure was totally laparoscopic in 30 patients (93.7%). Aortic approaches included left retrorenal (n = 24) and transperitoneal left retrocolic (n = 8) exposures. Median operative and clamping times were 270 (range 215-410) and 83 (range 36-147) min, respectively. Aortic clamping was suprarenal in 14 cases (43.7%), with suprarenal clamping time of 24 min (range 9-37). Median blood loss was 850 mL (range 215-2,400). Thirty-day mortality was 3.1% (one patient died from myocardial infarction). Two patients presented with severe systemic complications (6.4%, postoperative coagulopathy with hemorrhagic syndrome, pneumopathy). Seventeen patients developed mild or moderate systemic nonlethal complications (53.1%): transient renal insufficiencies (n = 12), grade 1 ischemic colitis (n = 1), surrenal insufficiency (n = 1), myocardial ischemia (n = 1), and cardiac arythmia (n = 2). One patient was reoperated for an intestinal obstruction. Liquid diet was reintroduced after 1 day (range 1-13). Most patients were ambulatory by day 3 (range 2-17). Median lengths of stay were 48 hr (range 12-552) in the intensive care unit and 10 days (range 4-37) in the hospital. With a median follow-up of 27 months (range 1-50), 28 patients are alive, with complete recovery without graft anomalies. Three patients died, from pneumopathy (n = 1) and carcinoma (n = 2), respectively, at 29, 19, and 44 months' follow-up. Two patients presented stable juxta-renal aortic dilation <35 mm. Total laparoscopic juxtarenal AAA repair is feasible and worthwhile for patients with AAASN. Short- and midterm results match well with those of open surgery. Total laparoscopic repair in AAASN reduces the trauma of extensive surgical approaches. Based on these encouraging early results, we elected to perform laparoscopy whenever possible in good surgical risk patients with AASN.
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Affiliation(s)
- Isabelle Di Centa
- Department of Vascular Surgery, Ambroise Paré University Hospital, Assistance Publique Hôpitaux de Paris, Boulogne-Billancourt, France and Faculté de Médecine Paris-Ouest, René Descartes University, Paris, France
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Hybrid procedures for thoracoabdominal aortic aneurysms and chronic aortic dissections - a single center experience in 28 patients. J Vasc Surg 2008; 47:724-32. [PMID: 18381133 DOI: 10.1016/j.jvs.2007.12.009] [Citation(s) in RCA: 107] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2007] [Revised: 12/04/2007] [Accepted: 12/06/2007] [Indexed: 11/22/2022]
Abstract
OBJECTIVE We report our 6-year experience with the visceral hybrid procedure for high-risk patients with thoracoabdominal aortic aneurysms (TAAA) and chronic expanding aortic dissections (CEAD). METHODS Hybrid procedure includes debranching of the visceral and renal arteries followed by endovascular exclusion of the aneurysm. A series of 28 patients (20 male, mean age 66 years) were treated between January 2001 and July 2007. Sixteen patients had TAAAs type I-III, one type IV, four thoracoabdominal placque ruptures, and seven patients CEAD. Patients were treated for asymptomatic, symptomatic, and ruptured aortic pathologies in 20, and 4 patients, respectively. Two patients had Marfan's syndrome; 61% had previous infrarenal aortic surgery. The infrarenal aorta was the distal landing zone in 70%. In elective cases, simultaneous approach (n = 9, group I) and staged approach (n = 11, group II) were performed. Mean follow-up is 22 months (range 0.1-78). RESULTS Primary technical success was achieved in 89%. All stent grafts were implanted in the entire thoracoabdominal aorta. Additionally, three patients had previous complete arch vessel revascularization. Left subclavian artery was intentionally covered in three patients (11%). Thirty-day mortality rate was 14.3% (4/28). One patient had a rupture before the staged endovascular procedure and died. Overall survival rate at 3 years was 70%, in group I 80%, and in group II 60% (P = .234). Type I endoleak rate was 8%. Permanent paraplegia rate was 11%. Three patients required long-term dialysis (11%). Peripheral graft occlusion rate was 11% at 30 days. Gut infarction with consecutive bowel resection occurred in two patients. There was no significant difference between group I and II regarding paraplegia and complications. CONCLUSIONS Early results of visceral hybrid repair for high-risk patients with complex and extended TAAAs and CEADs are encouraging in a selected group of high risk patients in whom open repair is hazardous and branched endografts are not yet optional.
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Starnes BW, Tran NT, McDonald JM. Hybrid Approaches to Repair of Complex Aortic Aneurysmal Disease. Surg Clin North Am 2007; 87:1087-98, ix. [DOI: 10.1016/j.suc.2007.08.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Hybridverfahren zur Therapie thorakoabdomineller Aortenaneurysmen (TAAA). GEFASSCHIRURGIE 2007. [DOI: 10.1007/s00772-007-0553-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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