TEVAR Following FET: Current Outcomes of Rendezvous Procedures in Clinical Practice.
Thorac Cardiovasc Surg
; 70(4): 314-322, 2022 06.
Article
em En
| MEDLINE
| ID: mdl-33580489
ABSTRACT
BACKGROUND:
The treatment of extensive thoracic/thoracoabdominal aortic pathologies with arch involvement remains a challenging task in aortic surgery. The introduction of the frozen elephant trunk (FET) technique offered a link between open surgery and thoracic endovascular aortic repair (TEVAR). Despite a decade of experience, data on the complementary use of these techniques are scant. The aim of this study was to evaluate TEVAR following FET in clinical reality.METHODS:
Between November 2006 and June 2018, 20 patients (9 females; median age of 69 years) underwent endovascular second-stage completion after FET. The clinical outcomes, technical feasibility, and morphological findings were analyzed retrospectively.RESULTS:
Eleven of the 20 interventions were intended "rendezvous procedures" in a multistage approach; 4 were elective reinterventions, and 5 were emergency complication repairs. The median interval between FET and TEVAR was 231 days (11 days-7.4 years). The technical success rate was 100%. During a median follow-up (FU) period of 58.3 months, the overall survival rate was 95%, with one in-hospital death. Neurological complications occurred in three cases (spinal cord injury n = 1; stroke n = 2). Computed tomography angiography showed overall regression in the median diameter of the proximal descending aorta (from 57 to 48.5 mm).CONCLUSION:
TEVAR as a second-stage intervention after FET is a feasible option, with satisfactory results at medium-term FU. In extensive thoracoabdominal aortic disease without proximal landing zones, the complementary use of both techniques in a multistage approach should be considered.
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Base de dados:
MEDLINE
Assunto principal:
Aneurisma da Aorta Torácica
/
Implante de Prótese Vascular
/
Procedimentos Endovasculares
Tipo de estudo:
Observational_studies
Limite:
Aged
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Female
/
Humans
Idioma:
En
Ano de publicação:
2022
Tipo de documento:
Article