Title :

Endovascular treatment of post type a chronic aortic arch dissection with a branched endograft: early results from a retrospective international multicenter study

Author(s) :

Verscheure, Dorian [Auteur]
Pôle des Cardiopathies Congénitales du Nouveau-Né à L'adulte - Centre Constitutif Cardiopathies Congénitales Complexes M3C, Groupe Hospitalier Paris Saint-Joseph, Hôpital Marie-Lannelongue, Inserm U999, Université Paris-Saclay
Haulon, Stephan [Auteur]
Hôpital Marie-Lannelongue
Tsilimparis, Nikolaos [Auteur]
University Heart Center [Hamburg]
Resch, Timothy [Auteur]
Skane University Hospital [Lund]
Wanhainen, Anders [Auteur]
Uppsala Universitet [Uppsala]
Mani, Kevin [Auteur]
Uppsala University Hospital
Dias, Nuno V. [Auteur]
Skane University Hospital [Malmo]
Sobocinski, Jonathan [Auteur]
Advanced Drug Delivery Systems (ADDS) - U1008
Eagleton, Matthew [Auteur]
Massachusetts General Hospital [Boston]
Ferreira, Marcelo [Auteur]
Universidade de São Paulo = University of São Paulo [USP]
Schurink, Geert Willem [Auteur]
Maastricht University Medical Centre [MUMC]
Modarai, Bijan [Auteur]
Guy's and St Thomas' NHS Foundation Trust
Abisi, Said [Auteur]
Guy's and St Thomas' NHS Foundation Trust
Kasprzak, Piotr [Auteur]
University of Regensburg
Adam, Donald [Auteur]
University Hospitals Birmingham [Birmingham, Royaume-Uni]
Cheng, Stephen [Auteur]
The University of Hong Kong [HKU]
Maurel, Blandine [Auteur]
Institut du Thorax [Nantes]
Jakimowicz, Thomasz [Auteur]
Medical University of Warsaw - Poland
Watkins, Amelia Claire [Auteur]
Stanford University
Sonesson, Bjorn [Auteur]
Skane University Hospital [Lund]
Claridge, Martin [Auteur]
University Hospitals Birmingham [Birmingham, Royaume-Uni]
Fabre, Dominique [Auteur]
Hôpital Marie-Lannelongue
Kolbel, Tilo [Auteur]
University Heart Center [Hamburg]

Journal title :

Annals of Surgery

Abbreviated title :

Ann. Surg.

Volume number :

273

Pages :

997-1003

Publication date :

2019-04-08

ISSN :

1528-1140

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

MINI: The objective of this study was to evaluate the outcome of endovascular repair of chronic aortic arch dissecting aneurysms with a custom-made branched endograft during follow-up after acute type A aortic dissection ...
Show more >MINI: The objective of this study was to evaluate the outcome of endovascular repair of chronic aortic arch dissecting aneurysms with a custom-made branched endograft during follow-up after acute type A aortic dissection open repair. Unmatched outcomes are reported in a population at high risk for a redo sternotomy. OBJECTIVE: The objective of this study was to evaluate the outcome of endovascular aortic arch repair for chronic dissection with a custom-made branched endograft. BACKGROUND: Acute type A aortic dissections are often treated with prosthetic replacement of the ascending aorta. During follow-up, repair of an aneurysmal evolution of the false lumen distal to the ascending prosthesis can be a challenge both for the surgeon and the patient. METHODS: We conducted a multicenter, retrospective study of consecutive patients from 14 vascular units treated with a custom-made, inner-branched device (Cook Medical, Bloomington, IN) for chronic aortic arch dissection. Rates of in-hospital mortality and stroke, technical success, early and late complications, reinterventions, and mortality during follow-up were evaluated. RESULTS: Seventy consecutive patients were treated between 2011 and 2018. All patients were considered unfit for conventional surgery. In-hospital combined mortality and stroke rate was 4% (n = 3), including 1 minor stroke, 1 major stroke causing death, and 1 death following multiorgan failure. Technical success rate was 94.3%. Twelve (17.1%) patients required early reinterventions: 8 for vascular access complication, 2 for endoleak correction, and 2 for pericardial effusion drainage. Median follow-up was 301 (138-642) days. During follow-up, 20 (29%) patients underwent secondary interventions: 9 endoleak corrections, 1 open repair for prosthetic kink, and 10 distal extensions of the graft to the thoracic or thoracoabdominal aorta. Eight patients (11%) died during follow-up because of nonaortic-related cause in 7 cases. CONCLUSIONS: Endovascular treatment of aortic arch chronic dissections with a branched endograft is associated with low mortality and stroke rates but has a high reintervention rate. Further follow-up is required to confirm the benefits of this novel approach.Show less >

Language :

Anglais

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

CHU Lille
Inserm
Université de Lille

Collections :

• Advanced Drug Delivery Systems (ADDS) - U1008

Submission date :

2021-01-20T15:58:59Z
2024-02-23T13:48:42Z