Comparison of single and multistage ...
Type de document :
Article dans une revue scientifique: Article original
PMID :
URL permanente :
Titre :
Comparison of single and multistage strategies during fenestrated-branched endovascular aortic repair of thoracoabdominal aortic aneurysms.
Auteur(s) :
Dias-Neto, M. [Auteur]
Tenorio, E. R. [Auteur]
Huang, Y. [Auteur]
Jakimowicz, T. [Auteur]
Mendes, B. C. [Auteur]
Kolbel, T. [Auteur]
Sobocinski, Jonathan [Auteur]
Advanced Drug Delivery Systems (ADDS) - U1008
Bertoglio, L. [Auteur]
Mees, B. [Auteur]
Gargiulo, M. [Auteur]
Dias, N. [Auteur]
Schanzer, A. [Auteur]
Gasper, W. [Auteur]
Beck, A. W. [Auteur]
Farber, M. A. [Auteur]
Mani, K. [Auteur]
Timaran, C. [Auteur]
Schneider, D. B. [Auteur]
Mendes Pedro, L. [Auteur]
Tsilimparis, N. [Auteur]
Haulon, S. [Auteur]
Sweet, M. [Auteur]
Ferreira, E. [Auteur]
Eagleton, M. [Auteur]
Yeung, K. K. [Auteur]
Khashram, M. [Auteur]
Varcica, A. [Auteur]
Lima, G. B. [Auteur]
Baghbani-Oskouei, A. [Auteur]
Jama, K. [Auteur]
Panuccio, G. [Auteur]
Rohlffs, F. [Auteur]
Chiesa, R. [Auteur]
Schurink, G. W. [Auteur]
Lemmens, C. [Auteur]
Gallitto, E. [Auteur]
Faggioli, G. [Auteur]
Karelis, A. [Auteur]
Parodi, E. [Auteur]
Gomes, V. [Auteur]
Wanhainen, A. [Auteur]
Dean, A. [Auteur]
Colon, J. P. [Auteur]
Pavarino, F. [Auteur]
Gouveia E Melo, R. [Auteur]
Crawford, S. [Auteur]
Garcia, R. [Auteur]
Ribeiro, T. [Auteur]
Kappe, K. O. [Auteur]
Van Knippenberg, S. E. M. [Auteur]
Lan Tran, B. [Auteur]
Gormley, S. [Auteur]
Oderich, Gustavo S. [Auteur]
The University of Texas Health Science Center at Houston [UTHealth]
Tenorio, E. R. [Auteur]
Huang, Y. [Auteur]
Jakimowicz, T. [Auteur]
Mendes, B. C. [Auteur]
Kolbel, T. [Auteur]
Sobocinski, Jonathan [Auteur]
Advanced Drug Delivery Systems (ADDS) - U1008
Bertoglio, L. [Auteur]
Mees, B. [Auteur]
Gargiulo, M. [Auteur]
Dias, N. [Auteur]
Schanzer, A. [Auteur]
Gasper, W. [Auteur]
Beck, A. W. [Auteur]
Farber, M. A. [Auteur]
Mani, K. [Auteur]
Timaran, C. [Auteur]
Schneider, D. B. [Auteur]
Mendes Pedro, L. [Auteur]
Tsilimparis, N. [Auteur]
Haulon, S. [Auteur]
Sweet, M. [Auteur]
Ferreira, E. [Auteur]
Eagleton, M. [Auteur]
Yeung, K. K. [Auteur]
Khashram, M. [Auteur]
Varcica, A. [Auteur]
Lima, G. B. [Auteur]
Baghbani-Oskouei, A. [Auteur]
Jama, K. [Auteur]
Panuccio, G. [Auteur]
Rohlffs, F. [Auteur]
Chiesa, R. [Auteur]
Schurink, G. W. [Auteur]
Lemmens, C. [Auteur]
Gallitto, E. [Auteur]
Faggioli, G. [Auteur]
Karelis, A. [Auteur]
Parodi, E. [Auteur]
Gomes, V. [Auteur]
Wanhainen, A. [Auteur]
Dean, A. [Auteur]
Colon, J. P. [Auteur]
Pavarino, F. [Auteur]
Gouveia E Melo, R. [Auteur]
Crawford, S. [Auteur]
Garcia, R. [Auteur]
Ribeiro, T. [Auteur]
Kappe, K. O. [Auteur]
Van Knippenberg, S. E. M. [Auteur]
Lan Tran, B. [Auteur]
Gormley, S. [Auteur]
Oderich, Gustavo S. [Auteur]
The University of Texas Health Science Center at Houston [UTHealth]
Titre de la revue :
Journal of Vascular Surgery
Nom court de la revue :
J Vasc Surg
Éditeur :
Elsevier
Date de publication :
2023-02-28
ISSN :
1097-6809
Discipline(s) HAL :
Sciences du Vivant [q-bio]
Résumé en anglais : [en]
Objective
The aim of this study was to compare outcomes of single or multistage approach during fenestrated-branched endovascular aortic repair (FB-EVAR) of extensive thoracoabdominal aortic aneurysms (TAAAs).
Methods
We ...
Lire la suite >Objective The aim of this study was to compare outcomes of single or multistage approach during fenestrated-branched endovascular aortic repair (FB-EVAR) of extensive thoracoabdominal aortic aneurysms (TAAAs). Methods We reviewed the clinical data of consecutive patients treated by FB-EVAR for extent I to III TAAAs in 24 centers (2006-2021). All patients received a single brand manufactured patient-specific or off-the-shelf fenestrated-branched stent grafts. Staging strategies included proximal thoracic aortic repair, minimally invasive segmental artery coil embolization, temporary aneurysm sac perfusion and combinations of these techniques. Endpoints were analyzed for elective repair in patients who had a single- or multistage approach before and after propensity score adjustment for baseline differences, including the composite 30-day/in-hospital mortality and/or permanent paraplegia, major adverse event, patient survival, and freedom from aortic-related mortality. Results A total of 1947 patients (65% male; mean age, 71 ± 8 years) underwent FB-EVAR of 155 extent I (10%), 729 extent II (46%), and 713 extent III TAAAs (44%). A single-stage approach was used in 939 patients (48%) and a multistage approach in 1008 patients (52%). A multistage approach was more frequently used in patients undergoing elective compared with non-elective repair (55% vs 35%; P < .001). Staging strategies were proximal thoracic aortic repair in 743 patients (74%), temporary aneurysm sac perfusion in 128 (13%), minimally invasive segmental artery coil embolization in 10 (1%), and combinations in 127 (12%). Among patients undergoing elective repair (n = 1597), the composite endpoint of 30-day/in-hospital mortality and/or permanent paraplegia rate occurred in 14% of single-stage and 6% of multistage approach patients (P < .001). After adjustment with a propensity score, multistage approach was associated with lower rates of 30-day/in-hospital mortality and/or permanent paraplegia (odds ratio, 0.466; 95% confidence interval, 0.271-0.801; P = .006) and higher patient survival at 1 year (86.9±1.3% vs 79.6±1.7%) and 3 years (72.7±2.1% vs 64.2±2.3%; adjusted hazard ratio, 0.714; 95% confidence interval, 0.528-0.966; P = .029), compared with a single stage approach. Conclusion Staging elective FB-EVAR of extent I to III TAAAs was associated with decreased risk of mortality and/or permanent paraplegia at 30 days or within hospital stay, and with higher patient survival at 1 and 3 years.Lire moins >
Lire la suite >Objective The aim of this study was to compare outcomes of single or multistage approach during fenestrated-branched endovascular aortic repair (FB-EVAR) of extensive thoracoabdominal aortic aneurysms (TAAAs). Methods We reviewed the clinical data of consecutive patients treated by FB-EVAR for extent I to III TAAAs in 24 centers (2006-2021). All patients received a single brand manufactured patient-specific or off-the-shelf fenestrated-branched stent grafts. Staging strategies included proximal thoracic aortic repair, minimally invasive segmental artery coil embolization, temporary aneurysm sac perfusion and combinations of these techniques. Endpoints were analyzed for elective repair in patients who had a single- or multistage approach before and after propensity score adjustment for baseline differences, including the composite 30-day/in-hospital mortality and/or permanent paraplegia, major adverse event, patient survival, and freedom from aortic-related mortality. Results A total of 1947 patients (65% male; mean age, 71 ± 8 years) underwent FB-EVAR of 155 extent I (10%), 729 extent II (46%), and 713 extent III TAAAs (44%). A single-stage approach was used in 939 patients (48%) and a multistage approach in 1008 patients (52%). A multistage approach was more frequently used in patients undergoing elective compared with non-elective repair (55% vs 35%; P < .001). Staging strategies were proximal thoracic aortic repair in 743 patients (74%), temporary aneurysm sac perfusion in 128 (13%), minimally invasive segmental artery coil embolization in 10 (1%), and combinations in 127 (12%). Among patients undergoing elective repair (n = 1597), the composite endpoint of 30-day/in-hospital mortality and/or permanent paraplegia rate occurred in 14% of single-stage and 6% of multistage approach patients (P < .001). After adjustment with a propensity score, multistage approach was associated with lower rates of 30-day/in-hospital mortality and/or permanent paraplegia (odds ratio, 0.466; 95% confidence interval, 0.271-0.801; P = .006) and higher patient survival at 1 year (86.9±1.3% vs 79.6±1.7%) and 3 years (72.7±2.1% vs 64.2±2.3%; adjusted hazard ratio, 0.714; 95% confidence interval, 0.528-0.966; P = .029), compared with a single stage approach. Conclusion Staging elective FB-EVAR of extent I to III TAAAs was associated with decreased risk of mortality and/or permanent paraplegia at 30 days or within hospital stay, and with higher patient survival at 1 and 3 years.Lire moins >
Langue :
Anglais
Audience :
Internationale
Établissement(s) :
Université de Lille
Inserm
CHU Lille
Inserm
CHU Lille
Collections :
Date de dépôt :
2023-05-08T14:30:49Z
2023-05-17T08:15:34Z
2023-05-17T08:15:34Z