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Szeto WY, Vallabhajosyula P, Matsuda H, Moainie SL, Sharafuddin MJ, Corvera J, Smolock CJ, Miyamoto S, Naslund T, Ramaiah V. One-Year Results with a Low-Profile Endograft in Subjects with Thoracic Aortic Aneurysm and Ulcer Pathologies. J Thorac Cardiovasc Surg 2022; 163:1739-1750.e4. [DOI: 10.1016/j.jtcvs.2021.10.071] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 09/30/2021] [Accepted: 10/19/2021] [Indexed: 11/29/2022]
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Zhu Y, Zhan W, Hamady M, Xu XY. A pilot study of aortic hemodynamics before and after thoracic endovascular repair with a double-branched endograft. MEDICINE IN NOVEL TECHNOLOGY AND DEVICES 2019. [DOI: 10.1016/j.medntd.2020.100027] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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3
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Marrocco-Trischitta MM, Spampinato B, Mazzeo G, Mazzaccaro D, Milani V, Alaidroos M, Ambrogi F, Nano G. Impact of the Bird-Beak Configuration on Postoperative Outcome After Thoracic Endovascular Aortic Repair: A Meta-analysis. J Endovasc Ther 2019; 26:771-778. [DOI: 10.1177/1526602819865906] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Purpose: To investigate the association between the bird-beak configuration (BBC), a wedge-shaped gap between the undersurface of a thoracic endograft and the lesser curvature of the arch after thoracic endovascular aortic repair (TEVAR), and postoperative outcome after TEVAR. Methods: The study was performed according to the PRISMA guidelines. The PubMed, EMBASE, and Cochrane databases were searched to identify all case series reporting BBC after TEVAR between 2006 and April 2018. Data analysis was performed considering the difference in the risk of complications for presence vs absence of BBC. After screening 1633 articles, 21 studies were identified that matched the selection criteria; 12 of these reported detailed information to investigate the postoperative outcome using proportion meta-analysis with a random effects model. The pooled risk difference is reported with the 95% confidence interval (CI). Heterogeneity of the included studies was assessed with the I2 statistic (low 25%, medium 50%, high 75%). Results: Complications occurred within a range of 0 to 72 months in 14.7% (95% CI 7.4% to 27.3%) of patients with BBC and in 6.3% (95% CI 2.5% to 15.4%) of patients without BBC. A cumulative incidence could not be assessed. The summary risk difference was 11.1% (95% CI −0.1% to 22.3%, p=0.052). There was significant heterogeneity ( I2=85.6%). The Egger test did not show evidence of publication bias (p=0.975). When specifically considering type Ia endoleak and endograft migration, the risk difference between BBC and non-BBC patients was 8.2% (95% CI 0.3% to 16.1%, p=0.042; I2=69.0%). The specific risk difference for endograft collapse/infolding and thrombosis was 3.7% (95% CI −3.5% to 11.1%, p=0.308; I2=10.2%). Conclusion: At present the literature does not provide statistical evidence to establish an overall prognostic value of the BBC. Nevertheless, the BBC appears to be associated with a high risk of type Ia endoleak and endograft migration, which warrants specific and long-term surveillance. Clinically relevant values for BBC grading should be established to perhaps define indications for preemptive treatment based on the presence of BBC only.
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Affiliation(s)
- Massimiliano M. Marrocco-Trischitta
- Clinical Research Unit, Cardiovascular Department, IRCCS Policlinico San Donato, Milan, Italy
- Vascular Surgery Unit, Cardiovascular Department, IRCCS Policlinico San Donato, Milan, Italy
| | - Benedetta Spampinato
- Vascular Surgery Unit, Cardiovascular Department, IRCCS Policlinico San Donato, Milan, Italy
- Residency Program in Vascular Surgery, University of Milan, Italy
| | - Girolomina Mazzeo
- Vascular Surgery Unit, Cardiovascular Department, IRCCS Policlinico San Donato, Milan, Italy
- Residency Program in Vascular Surgery, University of Milan, Italy
| | - Daniela Mazzaccaro
- Vascular Surgery Unit, Cardiovascular Department, IRCCS Policlinico San Donato, Milan, Italy
| | - Valentina Milani
- Biostatistics Service, IRCCS Policlinico San Donato, Milan Italy
| | - Moad Alaidroos
- Vascular Surgery Unit, Policlinico San Marco, Zingonia, Italy
| | - Federico Ambrogi
- Biostatistics Service, IRCCS Policlinico San Donato, Milan Italy
- Laboratory of Medical Statistics, University of Milan, Italy
| | - Giovanni Nano
- Vascular Surgery Unit, Cardiovascular Department, IRCCS Policlinico San Donato, Milan, Italy
- Department of “Scienze Biomediche per la Salute,” University of Milan, Italy
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Riesterer T, Beyersdorf F, Scheumann J, Berezowski M, Schröfel H, Kondov S, Czerny M, Rylski B. Accuracy of deployment of the Relay non-bare stent graft in the aortic arch. Interact Cardiovasc Thorac Surg 2018; 28:797-802. [DOI: 10.1093/icvts/ivy345] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Revised: 10/15/2018] [Accepted: 11/07/2018] [Indexed: 11/13/2022] Open
Affiliation(s)
- Tatjana Riesterer
- Department of Cardiovascular Surgery, Faculty of Medicine, Heart Center Freiburg University, University of Freiburg, Freiburg, Germany
| | - Friedhelm Beyersdorf
- Department of Cardiovascular Surgery, Faculty of Medicine, Heart Center Freiburg University, University of Freiburg, Freiburg, Germany
| | - Johannes Scheumann
- Department of Cardiovascular Surgery, Faculty of Medicine, Heart Center Freiburg University, University of Freiburg, Freiburg, Germany
| | - Mikolaj Berezowski
- Department of Cardiovascular Surgery, Faculty of Medicine, Heart Center Freiburg University, University of Freiburg, Freiburg, Germany
| | - Holger Schröfel
- Department of Cardiovascular Surgery, Faculty of Medicine, Heart Center Freiburg University, University of Freiburg, Freiburg, Germany
| | - Stoyan Kondov
- Department of Cardiovascular Surgery, Faculty of Medicine, Heart Center Freiburg University, University of Freiburg, Freiburg, Germany
| | - Martin Czerny
- Department of Cardiovascular Surgery, Faculty of Medicine, Heart Center Freiburg University, University of Freiburg, Freiburg, Germany
| | - Bartosz Rylski
- Department of Cardiovascular Surgery, Faculty of Medicine, Heart Center Freiburg University, University of Freiburg, Freiburg, Germany
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Georgakarakos E, Koutsoumpelis A, Popidis S, Tasopoulou KM, Georgiadis GS. A Complex Case of Synchronous Thoracic and Abdominal Endoleak Repair with Custom-Made Relay NBS Thoracic Stent Graft and Abdominal Open Reconstruction. Ann Vasc Surg 2018; 56:345-349. [PMID: 30496897 DOI: 10.1016/j.avsg.2018.08.101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 08/13/2018] [Accepted: 08/21/2018] [Indexed: 10/27/2022]
Abstract
A 71-year old man with previous thoracic aneurysm endovascular repair and endovascular abdominal aneurysm repair presented with simultaneous type III endoleak from the thoracic components and type Ia endoleak from migration of the abdominal endograft, leading to enlargement of both aneurysms. A custom-made reverse tapered Relay NBS thoracic endograft was used to bridge the thoracic stent grafts. While a low-flow type III endoleak persisted in the immediate postoperative phase, because of incomplete apposition of the new stent graft, further deployment of its nitinol skeleton resulted in resolution of the endoleak at 1-week follow-up. The abdominal aneurysm enlargement was corrected via excision of the central segment of the abdominal endograft, preservation of the distal main body and limbs, and interposition of a short Dacron tube graft.
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Affiliation(s)
- Efstratios Georgakarakos
- Democritus University of Thrace, Department of Vascular Surgery, University Hospital of Alexandroupolis, Alexandroupolis, Greece.
| | - Andreas Koutsoumpelis
- Democritus University of Thrace, Department of Vascular Surgery, University Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - Stefanos Popidis
- Democritus University of Thrace, Department of Vascular Surgery, University Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - Kalliopi-Maria Tasopoulou
- Democritus University of Thrace, Department of Vascular Surgery, University Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - George S Georgiadis
- Democritus University of Thrace, Department of Vascular Surgery, University Hospital of Alexandroupolis, Alexandroupolis, Greece
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van der Weijde E, Bakker OJ, Tielliu IFJ, Zeebregts CJ, Heijmen RH. Results From a Nationwide Registry on Scalloped Thoracic Stent-Grafts for Short Landing Zones. J Endovasc Ther 2016; 24:97-106. [DOI: 10.1177/1526602816674942] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Purpose: To report the perioperative results and short-term follow-up of patients treated with scalloped thoracic stent-grafts. Methods: A multicenter registry in the Netherlands captured data on 30 patients (mean age 68 years; 17 men) with thoracic aortic pathology and a short (<20 mm) proximal or distal landing zone who received a custom-made scalloped stent-graft between January 2013 and February 2016. Patients were treated for saccular (n=13) aneurysms, fusiform (n=9) aneurysms, pseudoaneurysms (n=4), or chronic type B dissections (n=4). The scallop was used to preserve flow in the left subclavian artery (LSA) (n=17), left common carotid artery (n=5), innominate artery (n=1), and celiac trunk (n=7). In 7 (23%) patients, the scallop also included the adjacent artery. Results: Technical success was achieved in 28 (93%) patients. In 1 patient, a minor type Ia endoleak was observed intraoperatively, which was no longer visible on computed tomography angiography at 3 months. In another patient, the LSA was unintentionally obstructed due to migration of the stent-graft on deployment. Concomitant carotid-carotid or carotid-subclavian bypass was performed in 4 patients. There was no retrograde type A dissection or conversion to open surgery. In-hospital mortality was 3%, and the perioperative ischemic stroke rate was 3%. At a mean follow-up of 9.7 months (range <1 to 31), 29 of 30 target vessels were patent. Conclusion: The scalloped stent-graft appears to be a safe and relatively simple alternative for the treatment of thoracic aortic lesions with short landing zones. Larger patient series and long-term follow-up are required to confirm these early results.
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Affiliation(s)
- Emma van der Weijde
- Department of Cardiothoracic Surgery, St Antonius Hospital, Nieuwegein, the Netherlands
| | - Olaf J. Bakker
- Department of Cardiothoracic Surgery, St Antonius Hospital, Nieuwegein, the Netherlands
- Department of Vascular & Endovascular Surgery, University Medical Centre Utrecht, the Netherlands
| | - Ignace F. J. Tielliu
- Department of Surgery (Division of Vascular Surgery), University Medical Center Groningen, University of Groningen, the Netherlands
| | - Clark J. Zeebregts
- Department of Surgery (Division of Vascular Surgery), University Medical Center Groningen, University of Groningen, the Netherlands
| | - Robin H. Heijmen
- Department of Cardiothoracic Surgery, St Antonius Hospital, Nieuwegein, the Netherlands
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Zipfel B, Zaefferer P, Riambau V, Szeberin Z, Weigang E, Menéndez M, Funovics M, Hamady M, Zipfel B, Zaefferer P, Riambau V, Szeberin Z, Weigang E, Menéndez M, Funovics M, Hamady M, Rousseau H, Mariné L, Kiskinis D, Bonneville JF, Kratimenos T, Nano G, Kato M, Gasparini D, Teebken O, Mangialardi N, Coppi G, Hoksbergen A, Heijmen RH. Worldwide results from the RESTORE II on elective endografting of thoracic aneurysms and dissections. J Vasc Surg 2016; 63:1466-75. [DOI: 10.1016/j.jvs.2015.12.032] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Accepted: 12/10/2015] [Indexed: 10/21/2022]
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Kamada T, Yoshioka K, Tanaka R, Makita S, Abiko A, Mukaida M, Ikai A, Okabayashi H. Strategy for thoracic endovascular aortic repair based on collateral circulation to the artery of Adamkiewicz. Surg Today 2015; 46:1024-30. [DOI: 10.1007/s00595-015-1272-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Accepted: 10/13/2015] [Indexed: 11/28/2022]
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Riambau V. Application of the Bolton Relay Device for Thoracic Endografting In or Near the Aortic Arch. AORTA : OFFICIAL JOURNAL OF THE AORTIC INSTITUTE AT YALE-NEW HAVEN HOSPITAL 2015; 3:16-24. [PMID: 26798752 DOI: 10.12945/j.aorta.2015.14-050] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2014] [Accepted: 12/05/2015] [Indexed: 11/18/2022]
Abstract
Endovascular correction of aortic arch pathology remains a challenge, with a variety of techniques proposed over the years to minimize complications and enhance the probability of a successful result. A variety of approaches have been developed in order to deal with the aortic arch pathology and its idiosyncrasies. We review potential interventional techniques for the repair of aortic arch pathologies, beginning with conventional aortic arch surgery, followed by hybrid treatments and those along the endovascular spectrum (parallel and fenestrated endografts, scalloped endografts, and ascending and new branched endografts). We finish with an overview of all the Bolton Medical (Barcelona, Spain and Sunrise, FL, USA) thoracic platforms. Endovascular techniques show acceptable results in selected cases. Both proximal Bolton Relay configurations (with and without a bare stent) offer conformability and accuracy on deployment with very low rates of stroke. Fenestrated and scalloped designs are also useful for selected cases. Ascending and branched Bolton devices are very promising platforms for a serious, full endovascular approach to the aorta.
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Affiliation(s)
- Vincent Riambau
- Vascular Surgery Division, Thorax Institute, Hospital Clinic of Barcelona, Barcelona, Spain
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Endovascular treatment of thoracic aortic aneurysms with a short proximal landing zone using scalloped endografts. J Vasc Surg 2014; 60:1499-506. [DOI: 10.1016/j.jvs.2014.08.062] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2014] [Accepted: 08/07/2014] [Indexed: 11/18/2022]
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