Results of chimney endovascular aneurysm repair as used in the PERICLES Registry to treat patients with suprarenal aortic pathologies
The prevailing evidence calls for using chimney/snorkel endovascular repair (ch-EVAR) with one or two chimney grafts. No studies up to now focus on its applicability and results for the treatment of suprarenal aortic pathologies (SRAP). Hence, we evaluated the clinical and radiologic results of ch-E...
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| creator | Taneva, Gergana T. Criado, Frank J. Torsello, Giovanni Veith, Frank Scali, Salvatore T. Kubilis, Paul Donas, Konstantinos P. Dalman, Ronald L. Tran, Kenneth Lee, Jason Pecoraro, Felice Bisdas, Theodosios Seifert, Sven Esche, Mirko Gasparini, Daniele Frigatti, Paolo Adovasio, Roberto Mucelli, Fabio Pozzi Damrauer, Scott M. Woo, Edward Y. Minion, David Salenius, Juha Suominen, Velipekka Mangialardi, Nicola Ronchey, Sonia Fazzini, Stefano Mestres, Gaspar Riambau, Vincent Mosquera, Nilo J. |
| description | The prevailing evidence calls for using chimney/snorkel endovascular repair (ch-EVAR) with one or two chimney grafts. No studies up to now focus on its applicability and results for the treatment of suprarenal aortic pathologies (SRAP). Hence, we evaluated the clinical and radiologic results of ch-EVAR treatment for SRAP placing three or more chimney grafts within the PERICLES Registry.
Data from 517 patients suffering complex aortic pathologies treated by ch-EVAR between 2008 and 2014 at 13 European and U.S. centers were retrospectively reviewed and analyzed.
Sixty-seven ch-EVAR-treated patients (12.9% of the entire PERICLES cohort) presented SRAP (83.5% elective, 16.5% urgent). The majority of patients (95.5%) received three chimney grafts; four patients received four chimney grafts. The Endurant device was the most commonly used (35.8%) followed by the Zenith abdominal endograft (19.4%). Overall, 204 chimney grafts were placed (56.7% covered self-expandable, 40.3% covered balloon-expandable stents, and 10.4% bare metal balloon-expandable stents). At a median follow-up of 24 months (range, 0.1-67.0 days), 30-day mortality was 6.1% (4 patients), and the overall mortality was 16.4% (11 patients). Overall survival was 87.4% (range, 79.5%-96.0%) at 1 year, 81.8% (range, 72.2%-92.2%) at 2 years and thereafter. Type IA endoleak was noted in nine patients (13.4%) intraoperatively and successfully treated in seven cases (97.1% technical success). Aneurysm sac diameter significantly decreased from 70.5 ± 19.3 mm to 66.9 ± 20.6 mm (P |
| doi_str_mv | 10.1016/j.jvs.2019.08.228 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2305800067</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S074152141932169X</els_id><sourcerecordid>2305800067</sourcerecordid><originalsourceid>FETCH-LOGICAL-c396t-5880eb068f98d3f0b0d8f19bff89b30b07cd4087fc35ead50e4f3bc7758b06b93</originalsourceid><addsrcrecordid>eNp9kEGP0zAQhS0EYrsLP4AL8pFLwjhpEkecUFVgpUqgAmfLccZbV0kcPE5RfwD_G1dd9shcRqN570nvY-yNgFyAqN8f8-OJ8gJEm4PMi0I-YysBbZPVEtrnbAXNWmRVIdY37JboCCBEJZuX7KYUtUgDK_Znj7QMkbi33BzcOOGZ49T7kyazDDpwPeESzjTygLN26Sa-EPbcTTwekH_b7u83u-13vscHRzGcefQ8BtSRzzo6nFL0bxcPnJY56ICTHrj2ITpz-R_84B8c0iv2wuqB8PXjvmM_P21_bL5ku6-f7zcfd5kp2zpmlZSAHdTStrIvLXTQSyvazlrZdmU6G9OvQTbWlBXqvgJc27IzTVPJ5Ora8o69u-bOwf9akKIaHRkchtTSL6SKEioJAHWTpOIqNcETBbRqDm7U4awEqAt9dVSJvrrQVyBVop88bx_jl27E_snxD3cSfLgKMJU8OQyKTGJksHcBTVS9d_-J_wt9-pgU</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2305800067</pqid></control><display><type>article</type><title>Results of chimney endovascular aneurysm repair as used in the PERICLES Registry to treat patients with suprarenal aortic pathologies</title><source>MEDLINE</source><source>Access via ScienceDirect (Elsevier)</source><source>EZB-FREE-00999 freely available EZB journals</source><creator>Taneva, Gergana T. ; Criado, Frank J. ; Torsello, Giovanni ; Veith, Frank ; Scali, Salvatore T. ; Kubilis, Paul ; Donas, Konstantinos P. ; Dalman, Ronald L. ; Tran, Kenneth ; Lee, Jason ; Pecoraro, Felice ; Bisdas, Theodosios ; Seifert, Sven ; Esche, Mirko ; Gasparini, Daniele ; Frigatti, Paolo ; Adovasio, Roberto ; Mucelli, Fabio Pozzi ; Damrauer, Scott M. ; Woo, Edward Y. ; Minion, David ; Salenius, Juha ; Suominen, Velipekka ; Mangialardi, Nicola ; Ronchey, Sonia ; Fazzini, Stefano ; Mestres, Gaspar ; Riambau, Vincent ; Mosquera, Nilo J.</creator><creatorcontrib>Taneva, Gergana T. ; Criado, Frank J. ; Torsello, Giovanni ; Veith, Frank ; Scali, Salvatore T. ; Kubilis, Paul ; Donas, Konstantinos P. ; Dalman, Ronald L. ; Tran, Kenneth ; Lee, Jason ; Pecoraro, Felice ; Bisdas, Theodosios ; Seifert, Sven ; Esche, Mirko ; Gasparini, Daniele ; Frigatti, Paolo ; Adovasio, Roberto ; Mucelli, Fabio Pozzi ; Damrauer, Scott M. ; Woo, Edward Y. ; Minion, David ; Salenius, Juha ; Suominen, Velipekka ; Mangialardi, Nicola ; Ronchey, Sonia ; Fazzini, Stefano ; Mestres, Gaspar ; Riambau, Vincent ; Mosquera, Nilo J. ; PERICLES collaborators</creatorcontrib><description>The prevailing evidence calls for using chimney/snorkel endovascular repair (ch-EVAR) with one or two chimney grafts. No studies up to now focus on its applicability and results for the treatment of suprarenal aortic pathologies (SRAP). Hence, we evaluated the clinical and radiologic results of ch-EVAR treatment for SRAP placing three or more chimney grafts within the PERICLES Registry.
Data from 517 patients suffering complex aortic pathologies treated by ch-EVAR between 2008 and 2014 at 13 European and U.S. centers were retrospectively reviewed and analyzed.
Sixty-seven ch-EVAR-treated patients (12.9% of the entire PERICLES cohort) presented SRAP (83.5% elective, 16.5% urgent). The majority of patients (95.5%) received three chimney grafts; four patients received four chimney grafts. The Endurant device was the most commonly used (35.8%) followed by the Zenith abdominal endograft (19.4%). Overall, 204 chimney grafts were placed (56.7% covered self-expandable, 40.3% covered balloon-expandable stents, and 10.4% bare metal balloon-expandable stents). At a median follow-up of 24 months (range, 0.1-67.0 days), 30-day mortality was 6.1% (4 patients), and the overall mortality was 16.4% (11 patients). Overall survival was 87.4% (range, 79.5%-96.0%) at 1 year, 81.8% (range, 72.2%-92.2%) at 2 years and thereafter. Type IA endoleak was noted in nine patients (13.4%) intraoperatively and successfully treated in seven cases (97.1% technical success). Aneurysm sac diameter significantly decreased from 70.5 ± 19.3 mm to 66.9 ± 20.6 mm (P < .001) at last follow-up. Ischemic stroke or transient ischemic attack were noted in two patients (2.9%). Chimney occlusion was detected in six renal arteries (9.5%) and two superior mesenteric arteries (3.2%). No patients required chronic hemodialysis. All occluded superior mesenteric artery grafts were successfully rescued using endovascular approaches.
The midterm use of ch-EVAR for the treatment SRAP seems to be safe, highlighting its applicability for the treatment of rupture threatening pathologies and seal zone lengthening as in type IA endoleaks after EVAR. However, the incidence of type IA endoleaks, chimney graft occlusions, and ischemic stroke rates is higher compared with the prevailing single chimney evidence. Longer follow-up with more cases is needed to establish the exact performance of this treatment in SRAP.</description><identifier>ISSN: 0741-5214</identifier><identifier>EISSN: 1097-6809</identifier><identifier>DOI: 10.1016/j.jvs.2019.08.228</identifier><identifier>PMID: 31611110</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Aged ; Aged, 80 and over ; Aortic Diseases - diagnostic imaging ; Aortic Diseases - physiopathology ; Aortic Diseases - surgery ; Blood Vessel Prosthesis ; Blood Vessel Prosthesis Implantation - adverse effects ; Blood Vessel Prosthesis Implantation - instrumentation ; Complex aneurysms ; Endovascular Procedures - adverse effects ; Endovascular Procedures - instrumentation ; Europe ; Female ; Humans ; Male ; Mesenteric Artery, Superior - diagnostic imaging ; Mesenteric Artery, Superior - physiopathology ; Mesenteric Artery, Superior - surgery ; Multiple chimney EVAR ; Postoperative Complications - etiology ; Prosthesis Design ; Registries ; Renal Artery - diagnostic imaging ; Renal Artery - physiopathology ; Renal Artery - surgery ; Retrospective Studies ; Risk Factors ; Stents ; Superior mesenteric artery ; Suprarenal aneurysms ; Time Factors ; Treatment Outcome ; Triple chimney EVAR ; United States</subject><ispartof>Journal of vascular surgery, 2020-05, Vol.71 (5), p.1521-1527.e1</ispartof><rights>2019 Society for Vascular Surgery</rights><rights>Copyright © 2019 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c396t-5880eb068f98d3f0b0d8f19bff89b30b07cd4087fc35ead50e4f3bc7758b06b93</citedby><cites>FETCH-LOGICAL-c396t-5880eb068f98d3f0b0d8f19bff89b30b07cd4087fc35ead50e4f3bc7758b06b93</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jvs.2019.08.228$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31611110$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Taneva, Gergana T.</creatorcontrib><creatorcontrib>Criado, Frank J.</creatorcontrib><creatorcontrib>Torsello, Giovanni</creatorcontrib><creatorcontrib>Veith, Frank</creatorcontrib><creatorcontrib>Scali, Salvatore T.</creatorcontrib><creatorcontrib>Kubilis, Paul</creatorcontrib><creatorcontrib>Donas, Konstantinos P.</creatorcontrib><creatorcontrib>Dalman, Ronald L.</creatorcontrib><creatorcontrib>Tran, Kenneth</creatorcontrib><creatorcontrib>Lee, Jason</creatorcontrib><creatorcontrib>Pecoraro, Felice</creatorcontrib><creatorcontrib>Bisdas, Theodosios</creatorcontrib><creatorcontrib>Seifert, Sven</creatorcontrib><creatorcontrib>Esche, Mirko</creatorcontrib><creatorcontrib>Gasparini, Daniele</creatorcontrib><creatorcontrib>Frigatti, Paolo</creatorcontrib><creatorcontrib>Adovasio, Roberto</creatorcontrib><creatorcontrib>Mucelli, Fabio Pozzi</creatorcontrib><creatorcontrib>Damrauer, Scott M.</creatorcontrib><creatorcontrib>Woo, Edward Y.</creatorcontrib><creatorcontrib>Minion, David</creatorcontrib><creatorcontrib>Salenius, Juha</creatorcontrib><creatorcontrib>Suominen, Velipekka</creatorcontrib><creatorcontrib>Mangialardi, Nicola</creatorcontrib><creatorcontrib>Ronchey, Sonia</creatorcontrib><creatorcontrib>Fazzini, Stefano</creatorcontrib><creatorcontrib>Mestres, Gaspar</creatorcontrib><creatorcontrib>Riambau, Vincent</creatorcontrib><creatorcontrib>Mosquera, Nilo J.</creatorcontrib><creatorcontrib>PERICLES collaborators</creatorcontrib><title>Results of chimney endovascular aneurysm repair as used in the PERICLES Registry to treat patients with suprarenal aortic pathologies</title><title>Journal of vascular surgery</title><addtitle>J Vasc Surg</addtitle><description>The prevailing evidence calls for using chimney/snorkel endovascular repair (ch-EVAR) with one or two chimney grafts. No studies up to now focus on its applicability and results for the treatment of suprarenal aortic pathologies (SRAP). Hence, we evaluated the clinical and radiologic results of ch-EVAR treatment for SRAP placing three or more chimney grafts within the PERICLES Registry.
Data from 517 patients suffering complex aortic pathologies treated by ch-EVAR between 2008 and 2014 at 13 European and U.S. centers were retrospectively reviewed and analyzed.
Sixty-seven ch-EVAR-treated patients (12.9% of the entire PERICLES cohort) presented SRAP (83.5% elective, 16.5% urgent). The majority of patients (95.5%) received three chimney grafts; four patients received four chimney grafts. The Endurant device was the most commonly used (35.8%) followed by the Zenith abdominal endograft (19.4%). Overall, 204 chimney grafts were placed (56.7% covered self-expandable, 40.3% covered balloon-expandable stents, and 10.4% bare metal balloon-expandable stents). At a median follow-up of 24 months (range, 0.1-67.0 days), 30-day mortality was 6.1% (4 patients), and the overall mortality was 16.4% (11 patients). Overall survival was 87.4% (range, 79.5%-96.0%) at 1 year, 81.8% (range, 72.2%-92.2%) at 2 years and thereafter. Type IA endoleak was noted in nine patients (13.4%) intraoperatively and successfully treated in seven cases (97.1% technical success). Aneurysm sac diameter significantly decreased from 70.5 ± 19.3 mm to 66.9 ± 20.6 mm (P < .001) at last follow-up. Ischemic stroke or transient ischemic attack were noted in two patients (2.9%). Chimney occlusion was detected in six renal arteries (9.5%) and two superior mesenteric arteries (3.2%). No patients required chronic hemodialysis. All occluded superior mesenteric artery grafts were successfully rescued using endovascular approaches.
The midterm use of ch-EVAR for the treatment SRAP seems to be safe, highlighting its applicability for the treatment of rupture threatening pathologies and seal zone lengthening as in type IA endoleaks after EVAR. However, the incidence of type IA endoleaks, chimney graft occlusions, and ischemic stroke rates is higher compared with the prevailing single chimney evidence. Longer follow-up with more cases is needed to establish the exact performance of this treatment in SRAP.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Aortic Diseases - diagnostic imaging</subject><subject>Aortic Diseases - physiopathology</subject><subject>Aortic Diseases - surgery</subject><subject>Blood Vessel Prosthesis</subject><subject>Blood Vessel Prosthesis Implantation - adverse effects</subject><subject>Blood Vessel Prosthesis Implantation - instrumentation</subject><subject>Complex aneurysms</subject><subject>Endovascular Procedures - adverse effects</subject><subject>Endovascular Procedures - instrumentation</subject><subject>Europe</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Mesenteric Artery, Superior - diagnostic imaging</subject><subject>Mesenteric Artery, Superior - physiopathology</subject><subject>Mesenteric Artery, Superior - surgery</subject><subject>Multiple chimney EVAR</subject><subject>Postoperative Complications - etiology</subject><subject>Prosthesis Design</subject><subject>Registries</subject><subject>Renal Artery - diagnostic imaging</subject><subject>Renal Artery - physiopathology</subject><subject>Renal Artery - surgery</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Stents</subject><subject>Superior mesenteric artery</subject><subject>Suprarenal aneurysms</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><subject>Triple chimney EVAR</subject><subject>United States</subject><issn>0741-5214</issn><issn>1097-6809</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kEGP0zAQhS0EYrsLP4AL8pFLwjhpEkecUFVgpUqgAmfLccZbV0kcPE5RfwD_G1dd9shcRqN570nvY-yNgFyAqN8f8-OJ8gJEm4PMi0I-YysBbZPVEtrnbAXNWmRVIdY37JboCCBEJZuX7KYUtUgDK_Znj7QMkbi33BzcOOGZ49T7kyazDDpwPeESzjTygLN26Sa-EPbcTTwekH_b7u83u-13vscHRzGcefQ8BtSRzzo6nFL0bxcPnJY56ICTHrj2ITpz-R_84B8c0iv2wuqB8PXjvmM_P21_bL5ku6-f7zcfd5kp2zpmlZSAHdTStrIvLXTQSyvazlrZdmU6G9OvQTbWlBXqvgJc27IzTVPJ5Ora8o69u-bOwf9akKIaHRkchtTSL6SKEioJAHWTpOIqNcETBbRqDm7U4awEqAt9dVSJvrrQVyBVop88bx_jl27E_snxD3cSfLgKMJU8OQyKTGJksHcBTVS9d_-J_wt9-pgU</recordid><startdate>202005</startdate><enddate>202005</enddate><creator>Taneva, Gergana T.</creator><creator>Criado, Frank J.</creator><creator>Torsello, Giovanni</creator><creator>Veith, Frank</creator><creator>Scali, Salvatore T.</creator><creator>Kubilis, Paul</creator><creator>Donas, Konstantinos P.</creator><creator>Dalman, Ronald L.</creator><creator>Tran, Kenneth</creator><creator>Lee, Jason</creator><creator>Pecoraro, Felice</creator><creator>Bisdas, Theodosios</creator><creator>Seifert, Sven</creator><creator>Esche, Mirko</creator><creator>Gasparini, Daniele</creator><creator>Frigatti, Paolo</creator><creator>Adovasio, Roberto</creator><creator>Mucelli, Fabio Pozzi</creator><creator>Damrauer, Scott M.</creator><creator>Woo, Edward Y.</creator><creator>Minion, David</creator><creator>Salenius, Juha</creator><creator>Suominen, Velipekka</creator><creator>Mangialardi, Nicola</creator><creator>Ronchey, Sonia</creator><creator>Fazzini, Stefano</creator><creator>Mestres, Gaspar</creator><creator>Riambau, Vincent</creator><creator>Mosquera, Nilo J.</creator><general>Elsevier Inc</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>202005</creationdate><title>Results of chimney endovascular aneurysm repair as used in the PERICLES Registry to treat patients with suprarenal aortic pathologies</title><author>Taneva, Gergana T. ; Criado, Frank J. ; Torsello, Giovanni ; Veith, Frank ; Scali, Salvatore T. ; Kubilis, Paul ; Donas, Konstantinos P. ; Dalman, Ronald L. ; Tran, Kenneth ; Lee, Jason ; Pecoraro, Felice ; Bisdas, Theodosios ; Seifert, Sven ; Esche, Mirko ; Gasparini, Daniele ; Frigatti, Paolo ; Adovasio, Roberto ; Mucelli, Fabio Pozzi ; Damrauer, Scott M. ; Woo, Edward Y. ; Minion, David ; Salenius, Juha ; Suominen, Velipekka ; Mangialardi, Nicola ; Ronchey, Sonia ; Fazzini, Stefano ; Mestres, Gaspar ; Riambau, Vincent ; Mosquera, Nilo J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c396t-5880eb068f98d3f0b0d8f19bff89b30b07cd4087fc35ead50e4f3bc7758b06b93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Aortic Diseases - diagnostic imaging</topic><topic>Aortic Diseases - physiopathology</topic><topic>Aortic Diseases - surgery</topic><topic>Blood Vessel Prosthesis</topic><topic>Blood Vessel Prosthesis Implantation - adverse effects</topic><topic>Blood Vessel Prosthesis Implantation - instrumentation</topic><topic>Complex aneurysms</topic><topic>Endovascular Procedures - adverse effects</topic><topic>Endovascular Procedures - instrumentation</topic><topic>Europe</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Mesenteric Artery, Superior - diagnostic imaging</topic><topic>Mesenteric Artery, Superior - physiopathology</topic><topic>Mesenteric Artery, Superior - surgery</topic><topic>Multiple chimney EVAR</topic><topic>Postoperative Complications - etiology</topic><topic>Prosthesis Design</topic><topic>Registries</topic><topic>Renal Artery - diagnostic imaging</topic><topic>Renal Artery - physiopathology</topic><topic>Renal Artery - surgery</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Stents</topic><topic>Superior mesenteric artery</topic><topic>Suprarenal aneurysms</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><topic>Triple chimney EVAR</topic><topic>United States</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Taneva, Gergana T.</creatorcontrib><creatorcontrib>Criado, Frank J.</creatorcontrib><creatorcontrib>Torsello, Giovanni</creatorcontrib><creatorcontrib>Veith, Frank</creatorcontrib><creatorcontrib>Scali, Salvatore T.</creatorcontrib><creatorcontrib>Kubilis, Paul</creatorcontrib><creatorcontrib>Donas, Konstantinos P.</creatorcontrib><creatorcontrib>Dalman, Ronald L.</creatorcontrib><creatorcontrib>Tran, Kenneth</creatorcontrib><creatorcontrib>Lee, Jason</creatorcontrib><creatorcontrib>Pecoraro, Felice</creatorcontrib><creatorcontrib>Bisdas, Theodosios</creatorcontrib><creatorcontrib>Seifert, Sven</creatorcontrib><creatorcontrib>Esche, Mirko</creatorcontrib><creatorcontrib>Gasparini, Daniele</creatorcontrib><creatorcontrib>Frigatti, Paolo</creatorcontrib><creatorcontrib>Adovasio, Roberto</creatorcontrib><creatorcontrib>Mucelli, Fabio Pozzi</creatorcontrib><creatorcontrib>Damrauer, Scott M.</creatorcontrib><creatorcontrib>Woo, Edward Y.</creatorcontrib><creatorcontrib>Minion, David</creatorcontrib><creatorcontrib>Salenius, Juha</creatorcontrib><creatorcontrib>Suominen, Velipekka</creatorcontrib><creatorcontrib>Mangialardi, Nicola</creatorcontrib><creatorcontrib>Ronchey, Sonia</creatorcontrib><creatorcontrib>Fazzini, Stefano</creatorcontrib><creatorcontrib>Mestres, Gaspar</creatorcontrib><creatorcontrib>Riambau, Vincent</creatorcontrib><creatorcontrib>Mosquera, Nilo J.</creatorcontrib><creatorcontrib>PERICLES collaborators</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>Journal of vascular surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Taneva, Gergana T.</au><au>Criado, Frank J.</au><au>Torsello, Giovanni</au><au>Veith, Frank</au><au>Scali, Salvatore T.</au><au>Kubilis, Paul</au><au>Donas, Konstantinos P.</au><au>Dalman, Ronald L.</au><au>Tran, Kenneth</au><au>Lee, Jason</au><au>Pecoraro, Felice</au><au>Bisdas, Theodosios</au><au>Seifert, Sven</au><au>Esche, Mirko</au><au>Gasparini, Daniele</au><au>Frigatti, Paolo</au><au>Adovasio, Roberto</au><au>Mucelli, Fabio Pozzi</au><au>Damrauer, Scott M.</au><au>Woo, Edward Y.</au><au>Minion, David</au><au>Salenius, Juha</au><au>Suominen, Velipekka</au><au>Mangialardi, Nicola</au><au>Ronchey, Sonia</au><au>Fazzini, Stefano</au><au>Mestres, Gaspar</au><au>Riambau, Vincent</au><au>Mosquera, Nilo J.</au><aucorp>PERICLES collaborators</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Results of chimney endovascular aneurysm repair as used in the PERICLES Registry to treat patients with suprarenal aortic pathologies</atitle><jtitle>Journal of vascular surgery</jtitle><addtitle>J Vasc Surg</addtitle><date>2020-05</date><risdate>2020</risdate><volume>71</volume><issue>5</issue><spage>1521</spage><epage>1527.e1</epage><pages>1521-1527.e1</pages><issn>0741-5214</issn><eissn>1097-6809</eissn><abstract>The prevailing evidence calls for using chimney/snorkel endovascular repair (ch-EVAR) with one or two chimney grafts. No studies up to now focus on its applicability and results for the treatment of suprarenal aortic pathologies (SRAP). Hence, we evaluated the clinical and radiologic results of ch-EVAR treatment for SRAP placing three or more chimney grafts within the PERICLES Registry.
Data from 517 patients suffering complex aortic pathologies treated by ch-EVAR between 2008 and 2014 at 13 European and U.S. centers were retrospectively reviewed and analyzed.
Sixty-seven ch-EVAR-treated patients (12.9% of the entire PERICLES cohort) presented SRAP (83.5% elective, 16.5% urgent). The majority of patients (95.5%) received three chimney grafts; four patients received four chimney grafts. The Endurant device was the most commonly used (35.8%) followed by the Zenith abdominal endograft (19.4%). Overall, 204 chimney grafts were placed (56.7% covered self-expandable, 40.3% covered balloon-expandable stents, and 10.4% bare metal balloon-expandable stents). At a median follow-up of 24 months (range, 0.1-67.0 days), 30-day mortality was 6.1% (4 patients), and the overall mortality was 16.4% (11 patients). Overall survival was 87.4% (range, 79.5%-96.0%) at 1 year, 81.8% (range, 72.2%-92.2%) at 2 years and thereafter. Type IA endoleak was noted in nine patients (13.4%) intraoperatively and successfully treated in seven cases (97.1% technical success). Aneurysm sac diameter significantly decreased from 70.5 ± 19.3 mm to 66.9 ± 20.6 mm (P < .001) at last follow-up. Ischemic stroke or transient ischemic attack were noted in two patients (2.9%). Chimney occlusion was detected in six renal arteries (9.5%) and two superior mesenteric arteries (3.2%). No patients required chronic hemodialysis. All occluded superior mesenteric artery grafts were successfully rescued using endovascular approaches.
The midterm use of ch-EVAR for the treatment SRAP seems to be safe, highlighting its applicability for the treatment of rupture threatening pathologies and seal zone lengthening as in type IA endoleaks after EVAR. However, the incidence of type IA endoleaks, chimney graft occlusions, and ischemic stroke rates is higher compared with the prevailing single chimney evidence. Longer follow-up with more cases is needed to establish the exact performance of this treatment in SRAP.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>31611110</pmid><doi>10.1016/j.jvs.2019.08.228</doi><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0741-5214 |
| ispartof | Journal of vascular surgery, 2020-05, Vol.71 (5), p.1521-1527.e1 |
| issn | 0741-5214 1097-6809 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2305800067 |
| source | MEDLINE; Access via ScienceDirect (Elsevier); EZB-FREE-00999 freely available EZB journals |
| subjects | Aged Aged, 80 and over Aortic Diseases - diagnostic imaging Aortic Diseases - physiopathology Aortic Diseases - surgery Blood Vessel Prosthesis Blood Vessel Prosthesis Implantation - adverse effects Blood Vessel Prosthesis Implantation - instrumentation Complex aneurysms Endovascular Procedures - adverse effects Endovascular Procedures - instrumentation Europe Female Humans Male Mesenteric Artery, Superior - diagnostic imaging Mesenteric Artery, Superior - physiopathology Mesenteric Artery, Superior - surgery Multiple chimney EVAR Postoperative Complications - etiology Prosthesis Design Registries Renal Artery - diagnostic imaging Renal Artery - physiopathology Renal Artery - surgery Retrospective Studies Risk Factors Stents Superior mesenteric artery Suprarenal aneurysms Time Factors Treatment Outcome Triple chimney EVAR United States |
| title | Results of chimney endovascular aneurysm repair as used in the PERICLES Registry to treat patients with suprarenal aortic pathologies |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-28T04%3A31%3A55IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Results%20of%20chimney%20endovascular%20aneurysm%20repair%20as%20used%20in%20the%20PERICLES%20Registry%20to%20treat%20patients%20with%20suprarenal%20aortic%20pathologies&rft.jtitle=Journal%20of%20vascular%20surgery&rft.au=Taneva,%20Gergana%20T.&rft.aucorp=PERICLES%20collaborators&rft.date=2020-05&rft.volume=71&rft.issue=5&rft.spage=1521&rft.epage=1527.e1&rft.pages=1521-1527.e1&rft.issn=0741-5214&rft.eissn=1097-6809&rft_id=info:doi/10.1016/j.jvs.2019.08.228&rft_dat=%3Cproquest_cross%3E2305800067%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2305800067&rft_id=info:pmid/31611110&rft_els_id=S074152141932169X&rfr_iscdi=true |