OBJECTIVE: To review our experience of thoracic endovascular aortic repair (TEVAR) in patients with prior open aortic repair (OAR). MATERIALS AND METHODS: Stent-grafts were deployed in the arch, descending thoracic and thoracoabdominal aortae of 39, 13 and 5 patients, respectively, and in a deteriorated extra-anatomical prosthesis in one. The access route was the femoral artery in 10 of 23 patients with, and in 30 of 35 patients without a prior abdominal prosthesis. Prior prostheses and elephant trunks comprised 57 of 116 landing zones and 23 proximal landing zones, respectively. RESULTS: Three patients died before discharge. Type II endoleaks developed in six patients, and Types I and III developed in one patient each. Type I endoleaks were not found at landing zones comprising prosthetic grafts. The overall actuarial three-year survival rate including early mortality was 86.5%. CONCLUSION: The clinical outcomes of TEVAR were excellent, even in patients with prior OAR. Prosthetic grafts, including elephant trunks, provided good landing zones for TEVAR. Prostheses with larger-caliber designs are recommended for iliac artery reconstruction in future TEVAR.
OBJECTIVE: To review our experience of thoracic endovascular aortic repair (TEVAR) in patients with prior open aortic repair (OAR). MATERIALS AND METHODS: Stent-grafts were deployed in the arch, descending thoracic and thoracoabdominal aortae of 39, 13 and 5 patients, respectively, and in a deteriorated extra-anatomical prosthesis in one. The access route was the femoral artery in 10 of 23 patients with, and in 30 of 35 patients without a prior abdominal prosthesis. Prior prostheses and elephant trunks comprised 57 of 116 landing zones and 23 proximal landing zones, respectively. RESULTS: Three patients died before discharge. Type II endoleaks developed in six patients, and Types I and III developed in one patient each. Type I endoleaks were not found at landing zones comprising prosthetic grafts. The overall actuarial three-year survival rate including early mortality was 86.5%. CONCLUSION: The clinical outcomes of TEVAR were excellent, even in patients with prior OAR. Prosthetic grafts, including elephant trunks, provided good landing zones for TEVAR. Prostheses with larger-caliber designs are recommended for iliac artery reconstruction in future TEVAR.
Authors: Tad Kim; Tomas D Martin; W Anthony Lee; Philip J Hess; Charles T Klodell; Curtis G Tribble; Robert J Feezor; Thomas M Beaver Journal: J Thorac Cardiovasc Surg Date: 2009-03 Impact factor: 5.209
Authors: Christian D Etz; Stefano Zoli; Christoph S Mueller; Carol A Bodian; Gabriele Di Luozzo; Ricardo Lazala; Konstadinos A Plestis; Randall B Griepp Journal: J Thorac Cardiovasc Surg Date: 2010-06 Impact factor: 5.209
Authors: Nicholas T Kouchoukos; Michael C Mauney; Paolo Masetti; Catherine F Castner Journal: J Thorac Cardiovasc Surg Date: 2004-11 Impact factor: 5.209