Chun-Ku Chen1, I-Ping Liang2, Hsiao-Ting Chang3, Wei-Yuan Chen4, I-Ming Chen5, Mei-Han Wu1, Ming-Huei Sheu1, Chun-Che Shih6. 1. Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan. 2. Department of Radiology, Chiayi Branch, Taichung Veterans General Hospital, Chiayi, Taiwan. 3. School of Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Family Medicine, Taipei Hospital, Ministry of Health and Welfare, New Taipei City, Taiwan. 4. School of Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Surgery, Taipei Hospital, Ministry of Health and Welfare, New Taipei City, Taiwan. 5. School of Medicine, National Yang-Ming University, Taipei, Taiwan; Division of Cardiovascular Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan; Institutes of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan. 6. Division of Cardiovascular Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan; Institutes of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan. Electronic address: ccshih@vghtpe.gov.tw.
Abstract
OBJECTIVE: In this study, we assessed the association between the tortuosity of the thoracic aorta as measured by the reporting standards for thoracic endovascular aortic repair (TEVAR), described by the Society for Vascular Surgery, and midterm outcomes after TEVAR for atherosclerotic aneurysms. METHODS: We analyzed 77 consecutive patients who underwent TEVAR for atherosclerotic aneurysms from November 2006 through May 2013 in a single institution. The preoperative aortic tortuosity index (TI) was calculated by computed tomography aortography, and patients were divided into low-tortuosity (TI ≤ 1.29) and high-tortuosity (TI > 1.29) groups. The relationships between TI and the occurrence of endoleaks, complications, and survival were analyzed. RESULTS: The mean follow-up period was 29 ± 26 months. During this period, endoleaks occurred in 19 patients. Patients in the high-tortuosity group were at greater risk for endoleaks (odds ratio, 9.95; 95% confidence interval, 2.06-48.1; P = .004) and stroke (odds ratio, 13.2; 95% confidence interval, 1.03-169; P = .047) than those in the low-tortuosity group. The overall survival at 1, 3, and 5 years was 73%, 69%, and 63%, respectively, for the high-tortuosity group and 92%, 92%, and 86%, respectively, for the low tortuosity group. CONCLUSIONS: Our findings demonstrated that high tortuosity of the thoracic aorta is associated with higher rates of endoleaks and lower survival in patients undergoing TEVAR for atherosclerotic aneurysms. Patients with aneurysms in a highly tortuous aorta may therefore need greater attention in preoperative planning, perioperative procedures, and follow-up examinations.
OBJECTIVE: In this study, we assessed the association between the tortuosity of the thoracic aorta as measured by the reporting standards for thoracic endovascular aortic repair (TEVAR), described by the Society for Vascular Surgery, and midterm outcomes after TEVAR for atherosclerotic aneurysms. METHODS: We analyzed 77 consecutive patients who underwent TEVAR for atherosclerotic aneurysms from November 2006 through May 2013 in a single institution. The preoperative aortic tortuosity index (TI) was calculated by computed tomography aortography, and patients were divided into low-tortuosity (TI ≤ 1.29) and high-tortuosity (TI > 1.29) groups. The relationships between TI and the occurrence of endoleaks, complications, and survival were analyzed. RESULTS: The mean follow-up period was 29 ± 26 months. During this period, endoleaks occurred in 19 patients. Patients in the high-tortuosity group were at greater risk for endoleaks (odds ratio, 9.95; 95% confidence interval, 2.06-48.1; P = .004) and stroke (odds ratio, 13.2; 95% confidence interval, 1.03-169; P = .047) than those in the low-tortuosity group. The overall survival at 1, 3, and 5 years was 73%, 69%, and 63%, respectively, for the high-tortuosity group and 92%, 92%, and 86%, respectively, for the low tortuosity group. CONCLUSIONS: Our findings demonstrated that high tortuosity of the thoracic aorta is associated with higher rates of endoleaks and lower survival in patients undergoing TEVAR for atherosclerotic aneurysms. Patients with aneurysms in a highly tortuous aorta may therefore need greater attention in preoperative planning, perioperative procedures, and follow-up examinations.
Authors: Viony M Belvroy; Hector W L de Beaufort; Joost A van Herwaarden; Jean Bismuth; Gabriele Piffaretti; Frans L Moll; Santi Trimarchi Journal: World J Surg Date: 2020-04 Impact factor: 3.352
Authors: Markus Mach; Thomas Poschner; Waseem Hasan; Philipp Szalkiewicz; Martin Andreas; Bernhard Winkler; Stephanie Geisler; Daniela Geisler; Piotr N Rudziński; Victoria Watzal; Andreas Strouhal; Christopher Adlbrecht; Georg Delle-Karth; Martin Grabenwöger Journal: Eur J Clin Invest Date: 2021-02-02 Impact factor: 4.686