Hybrid Endovascular Repair for Aortic Arch Pathology: Intermediate Outcomes and Complications: A Retrospective Analysis
- Authors
- Kang, Woong Chol; Shin, Eak Kyun; Park, Chul-Hyun; Kang, Jin Mo; Ko, Young-Guk; Choi, Donghoon; Youn, Young Nam; Shim, Won-Heum
- Issue Date
- 1-Aug-2013
- Publisher
- WILEY
- Keywords
- aortic arch pathology; hybrid endovascular repair; stent-graft; supra-aortic vessel transposition
- Citation
- CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, v.82, no.2, pp.275 - 282
- Journal Title
- CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS
- Volume
- 82
- Number
- 2
- Start Page
- 275
- End Page
- 282
- URI
- https://scholarworks.bwise.kr/gachon/handle/2020.sw.gachon/14375
- DOI
- 10.1002/ccd.24384
- ISSN
- 1522-1946
- Abstract
- ObjectivesTo evaluate the outcomes of hybrid endovascular repair for aortic arch pathology. MethodsThis study was a retrospective analysis involving patients who underwent hybrid endovascular repair for aortic arch pathologies. ResultsTwenty-one patients (16 men; mean age, 64.7 16.2 years) with aortic arch pathologies were treated by hybrid endovascular repair. The indications for treatment included increased aneurysm size in 16 cases (71.4%), rupture or impending aneurysmal rupture in 5 cases (23.8%), and rapid growth of aortic dissection (10 mm/y) in 1 case (4.8%). Supra-aortic vessel transposition and stent-graft implantation were achieved in all cases. Two types of stent-graft was used, as follows: the Seal thoracic stent-graft in 14 patients (66.7%); and the Valiant stent grafts in 7 patients (33.3%). Perioperative complications affected 5 patients (23.8%), as follows: bleeding (n = 4, 19.0%); stroke (n = 3, 14.3%); renal failure (n = 2, 9.5%); vascular injury (n = 1, 4.8%), and respiratory failure (n = 1, 4.8%). Two patients died within 30 days (9.5%). Technical success was achieved in 15 patients (71.5%). Early endoleaks were noted in 4 patients (19.0%). One patient died during follow-up (mean, 21.3 +/- 11.6 months) due to a de novo intramural hematoma. Persistent early endoleaks were noted in 4 patients (19.0%); 2 of the 4 patients were successfully managed with implantation of additional stent-grafts. No late onset endoleaks were noted. The death-free survival and reintervention-free survival rates during follow-up were 85.7% and 90.5%, respectively. ConclusionHybrid treatment with supra-aortic vessel transposition and endovascular repair may be an option in frail patients in who open procedures is too risky. (c) 2013 Wiley Periodicals, Inc.
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