Clinical outcomes in hybrid repair procedures for pathologies involving the aortic arch
Objective Fifty patients with complex aortic disease, who received hybrid treatment of the aortic arch with supra-aortic debranching and endovascular stent-graft repair, were evaluated in regard to events of primary (survival and technical success) and secondary (procedure-related complications) int...
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| Veröffentlicht in: | Vascular 2015-02, Vol.23 (1), p.9-16 |
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| creator | Zerwes, Sebastian Leissner, Giesbert Gosslau, Yvonne Jakob, Rudolf Bruijnen, Hans-Kees Oertl, Frank Woelfle, Klaus |
| description | Objective
Fifty patients with complex aortic disease, who received hybrid treatment of the aortic arch with supra-aortic debranching and endovascular stent-graft repair, were evaluated in regard to events of primary (survival and technical success) and secondary (procedure-related complications) interest.
Methods
The single-center study was conducted over an eight-year period from December 2004 to December 2012. Treated medical conditions included 23 aortic aneurysms (46%), 21 aortic dissections (42%), and six penetrating aortic ulcers (12%). Procedures were divided into groups of elective, urgent, and emergent.
Results
Twenty-eight (56%) patients were operated electively, 15 (30%) urgently, and seven (14%) emergently. Sternotomy, cardiopulmonary bypass, and deep hypothermic circulatory arrest were required in 12 (24%) patients. The primary technical success rate was 86% and raised to 92% (n = 46) of secondary technical success rate after therapy of three type I endoleaks. The 30-day mortality added up to 16.0%, and the mean time of survival was 49.3 months. In a total of eight (16%) patients, an endoleak occurred (five endoleaks type I, three endoleaks type II), while nine (18%) of patients suffered a perioperative stroke.
Conclusions
In severely ill patients with complex aortic diseases, hybrid therapy may offer a promising alternative to conventional open repair. |
| doi_str_mv | 10.1177/1708538114525608 |
| format | Article |
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Fifty patients with complex aortic disease, who received hybrid treatment of the aortic arch with supra-aortic debranching and endovascular stent-graft repair, were evaluated in regard to events of primary (survival and technical success) and secondary (procedure-related complications) interest.
Methods
The single-center study was conducted over an eight-year period from December 2004 to December 2012. Treated medical conditions included 23 aortic aneurysms (46%), 21 aortic dissections (42%), and six penetrating aortic ulcers (12%). Procedures were divided into groups of elective, urgent, and emergent.
Results
Twenty-eight (56%) patients were operated electively, 15 (30%) urgently, and seven (14%) emergently. Sternotomy, cardiopulmonary bypass, and deep hypothermic circulatory arrest were required in 12 (24%) patients. The primary technical success rate was 86% and raised to 92% (n = 46) of secondary technical success rate after therapy of three type I endoleaks. The 30-day mortality added up to 16.0%, and the mean time of survival was 49.3 months. In a total of eight (16%) patients, an endoleak occurred (five endoleaks type I, three endoleaks type II), while nine (18%) of patients suffered a perioperative stroke.
Conclusions
In severely ill patients with complex aortic diseases, hybrid therapy may offer a promising alternative to conventional open repair.</description><identifier>ISSN: 1708-5381</identifier><identifier>EISSN: 1708-539X</identifier><identifier>DOI: 10.1177/1708538114525608</identifier><identifier>PMID: 24621559</identifier><language>eng</language><publisher>London, England: SAGE Publications</publisher><subject>Aged ; Aorta, Thoracic - diagnostic imaging ; Aorta, Thoracic - surgery ; Aortic Diseases - diagnosis ; Aortic Diseases - mortality ; Aortic Diseases - surgery ; Aortography - methods ; Blood Vessel Prosthesis ; Blood Vessel Prosthesis Implantation - adverse effects ; Blood Vessel Prosthesis Implantation - instrumentation ; Blood Vessel Prosthesis Implantation - mortality ; Cardiopulmonary Bypass ; Circulatory Arrest, Deep Hypothermia Induced ; Elective Surgical Procedures ; Emergencies ; Endoleak - etiology ; Endovascular Procedures - adverse effects ; Endovascular Procedures - instrumentation ; Endovascular Procedures - mortality ; Female ; Germany ; Humans ; Kaplan-Meier Estimate ; Male ; Prosthesis Design ; Retrospective Studies ; Risk Factors ; Stents ; Sternotomy ; Stroke - etiology ; Time Factors ; Tomography, X-Ray Computed ; Treatment Outcome</subject><ispartof>Vascular, 2015-02, Vol.23 (1), p.9-16</ispartof><rights>The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav</rights><rights>The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c337t-b218cb856811083b35c49c0b871698eeb6b7bb796aefb222dc00a821a1cd69873</citedby><cites>FETCH-LOGICAL-c337t-b218cb856811083b35c49c0b871698eeb6b7bb796aefb222dc00a821a1cd69873</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/1708538114525608$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/1708538114525608$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>314,776,780,21798,27901,27902,43597,43598</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24621559$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Zerwes, Sebastian</creatorcontrib><creatorcontrib>Leissner, Giesbert</creatorcontrib><creatorcontrib>Gosslau, Yvonne</creatorcontrib><creatorcontrib>Jakob, Rudolf</creatorcontrib><creatorcontrib>Bruijnen, Hans-Kees</creatorcontrib><creatorcontrib>Oertl, Frank</creatorcontrib><creatorcontrib>Woelfle, Klaus</creatorcontrib><title>Clinical outcomes in hybrid repair procedures for pathologies involving the aortic arch</title><title>Vascular</title><addtitle>Vascular</addtitle><description>Objective
Fifty patients with complex aortic disease, who received hybrid treatment of the aortic arch with supra-aortic debranching and endovascular stent-graft repair, were evaluated in regard to events of primary (survival and technical success) and secondary (procedure-related complications) interest.
Methods
The single-center study was conducted over an eight-year period from December 2004 to December 2012. Treated medical conditions included 23 aortic aneurysms (46%), 21 aortic dissections (42%), and six penetrating aortic ulcers (12%). Procedures were divided into groups of elective, urgent, and emergent.
Results
Twenty-eight (56%) patients were operated electively, 15 (30%) urgently, and seven (14%) emergently. Sternotomy, cardiopulmonary bypass, and deep hypothermic circulatory arrest were required in 12 (24%) patients. The primary technical success rate was 86% and raised to 92% (n = 46) of secondary technical success rate after therapy of three type I endoleaks. The 30-day mortality added up to 16.0%, and the mean time of survival was 49.3 months. In a total of eight (16%) patients, an endoleak occurred (five endoleaks type I, three endoleaks type II), while nine (18%) of patients suffered a perioperative stroke.
Conclusions
In severely ill patients with complex aortic diseases, hybrid therapy may offer a promising alternative to conventional open repair.</description><subject>Aged</subject><subject>Aorta, Thoracic - diagnostic imaging</subject><subject>Aorta, Thoracic - surgery</subject><subject>Aortic Diseases - diagnosis</subject><subject>Aortic Diseases - mortality</subject><subject>Aortic Diseases - surgery</subject><subject>Aortography - methods</subject><subject>Blood Vessel Prosthesis</subject><subject>Blood Vessel Prosthesis Implantation - adverse effects</subject><subject>Blood Vessel Prosthesis Implantation - instrumentation</subject><subject>Blood Vessel Prosthesis Implantation - mortality</subject><subject>Cardiopulmonary Bypass</subject><subject>Circulatory Arrest, Deep Hypothermia Induced</subject><subject>Elective Surgical Procedures</subject><subject>Emergencies</subject><subject>Endoleak - etiology</subject><subject>Endovascular Procedures - adverse effects</subject><subject>Endovascular Procedures - instrumentation</subject><subject>Endovascular Procedures - mortality</subject><subject>Female</subject><subject>Germany</subject><subject>Humans</subject><subject>Kaplan-Meier Estimate</subject><subject>Male</subject><subject>Prosthesis Design</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Stents</subject><subject>Sternotomy</subject><subject>Stroke - etiology</subject><subject>Time Factors</subject><subject>Tomography, X-Ray Computed</subject><subject>Treatment Outcome</subject><issn>1708-5381</issn><issn>1708-539X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kD1PwzAQhi0EolDYmVBGloDPjmNnRBVfUiUWEGyR7TiNqyQudlKp_x6Xlg5ITPf13Ku7F6ErwLcAnN8Bx4JRAZAxwnIsjtDZtpUyWnweH3IBE3QewhJjignkp2hCspwAY8UZ-pi1trdatokbB-06ExLbJ81GeVsl3qyk9cnKO22q0cdZ7WIph8a1bmF_2LVr17ZfJENjEun8YHUivW4u0Ekt22Au93GK3h8f3mbP6fz16WV2P081pXxIFQGhlWB5_AELqijTWaGxEhzyQhijcsWV4kUuTa0IIZXGWAoCEnQVAU6n6GanG4_8Gk0Yys4GbdpW9saNoYSckQxDgSGieIdq70Lwpi5X3nbSb0rA5dbO8q-dceV6rz6qzlSHhV__IpDugCAXply60ffx2_8FvwHLqX0X</recordid><startdate>20150201</startdate><enddate>20150201</enddate><creator>Zerwes, Sebastian</creator><creator>Leissner, Giesbert</creator><creator>Gosslau, Yvonne</creator><creator>Jakob, Rudolf</creator><creator>Bruijnen, Hans-Kees</creator><creator>Oertl, Frank</creator><creator>Woelfle, Klaus</creator><general>SAGE Publications</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20150201</creationdate><title>Clinical outcomes in hybrid repair procedures for pathologies involving the aortic arch</title><author>Zerwes, Sebastian ; Leissner, Giesbert ; Gosslau, Yvonne ; Jakob, Rudolf ; Bruijnen, Hans-Kees ; Oertl, Frank ; Woelfle, Klaus</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c337t-b218cb856811083b35c49c0b871698eeb6b7bb796aefb222dc00a821a1cd69873</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Aged</topic><topic>Aorta, Thoracic - diagnostic imaging</topic><topic>Aorta, Thoracic - surgery</topic><topic>Aortic Diseases - diagnosis</topic><topic>Aortic Diseases - mortality</topic><topic>Aortic Diseases - surgery</topic><topic>Aortography - methods</topic><topic>Blood Vessel Prosthesis</topic><topic>Blood Vessel Prosthesis Implantation - adverse effects</topic><topic>Blood Vessel Prosthesis Implantation - instrumentation</topic><topic>Blood Vessel Prosthesis Implantation - mortality</topic><topic>Cardiopulmonary Bypass</topic><topic>Circulatory Arrest, Deep Hypothermia Induced</topic><topic>Elective Surgical Procedures</topic><topic>Emergencies</topic><topic>Endoleak - etiology</topic><topic>Endovascular Procedures - adverse effects</topic><topic>Endovascular Procedures - instrumentation</topic><topic>Endovascular Procedures - mortality</topic><topic>Female</topic><topic>Germany</topic><topic>Humans</topic><topic>Kaplan-Meier Estimate</topic><topic>Male</topic><topic>Prosthesis Design</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Stents</topic><topic>Sternotomy</topic><topic>Stroke - etiology</topic><topic>Time Factors</topic><topic>Tomography, X-Ray Computed</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zerwes, Sebastian</creatorcontrib><creatorcontrib>Leissner, Giesbert</creatorcontrib><creatorcontrib>Gosslau, Yvonne</creatorcontrib><creatorcontrib>Jakob, Rudolf</creatorcontrib><creatorcontrib>Bruijnen, Hans-Kees</creatorcontrib><creatorcontrib>Oertl, Frank</creatorcontrib><creatorcontrib>Woelfle, Klaus</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Vascular</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zerwes, Sebastian</au><au>Leissner, Giesbert</au><au>Gosslau, Yvonne</au><au>Jakob, Rudolf</au><au>Bruijnen, Hans-Kees</au><au>Oertl, Frank</au><au>Woelfle, Klaus</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Clinical outcomes in hybrid repair procedures for pathologies involving the aortic arch</atitle><jtitle>Vascular</jtitle><addtitle>Vascular</addtitle><date>2015-02-01</date><risdate>2015</risdate><volume>23</volume><issue>1</issue><spage>9</spage><epage>16</epage><pages>9-16</pages><issn>1708-5381</issn><eissn>1708-539X</eissn><abstract>Objective
Fifty patients with complex aortic disease, who received hybrid treatment of the aortic arch with supra-aortic debranching and endovascular stent-graft repair, were evaluated in regard to events of primary (survival and technical success) and secondary (procedure-related complications) interest.
Methods
The single-center study was conducted over an eight-year period from December 2004 to December 2012. Treated medical conditions included 23 aortic aneurysms (46%), 21 aortic dissections (42%), and six penetrating aortic ulcers (12%). Procedures were divided into groups of elective, urgent, and emergent.
Results
Twenty-eight (56%) patients were operated electively, 15 (30%) urgently, and seven (14%) emergently. Sternotomy, cardiopulmonary bypass, and deep hypothermic circulatory arrest were required in 12 (24%) patients. The primary technical success rate was 86% and raised to 92% (n = 46) of secondary technical success rate after therapy of three type I endoleaks. The 30-day mortality added up to 16.0%, and the mean time of survival was 49.3 months. In a total of eight (16%) patients, an endoleak occurred (five endoleaks type I, three endoleaks type II), while nine (18%) of patients suffered a perioperative stroke.
Conclusions
In severely ill patients with complex aortic diseases, hybrid therapy may offer a promising alternative to conventional open repair.</abstract><cop>London, England</cop><pub>SAGE Publications</pub><pmid>24621559</pmid><doi>10.1177/1708538114525608</doi><tpages>8</tpages></addata></record> |
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| subjects | Aged Aorta, Thoracic - diagnostic imaging Aorta, Thoracic - surgery Aortic Diseases - diagnosis Aortic Diseases - mortality Aortic Diseases - surgery Aortography - methods Blood Vessel Prosthesis Blood Vessel Prosthesis Implantation - adverse effects Blood Vessel Prosthesis Implantation - instrumentation Blood Vessel Prosthesis Implantation - mortality Cardiopulmonary Bypass Circulatory Arrest, Deep Hypothermia Induced Elective Surgical Procedures Emergencies Endoleak - etiology Endovascular Procedures - adverse effects Endovascular Procedures - instrumentation Endovascular Procedures - mortality Female Germany Humans Kaplan-Meier Estimate Male Prosthesis Design Retrospective Studies Risk Factors Stents Sternotomy Stroke - etiology Time Factors Tomography, X-Ray Computed Treatment Outcome |
| title | Clinical outcomes in hybrid repair procedures for pathologies involving the aortic arch |
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