Soichiro Fukushima1, Takao Ohki2, Yuji Kanaoka1, Hiroki Ohta1, Makiko Ohmori1, Masamichi Momose1. 1. Division of Vascular Surgery, Department of Surgery, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan. 2. Division of Vascular Surgery, Department of Surgery, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan. Electronic address: takohki@msn.com.
Abstract
BACKGROUND: Anatomically suitable Crawford type I (C-I) thoracoabdominal aortic aneurysm (TAAA) can be treated by thoracic endovascular aneurysm repair (TEVAR) with intentional celiac artery (CA) coverage to ensure distal seal. We report on mid-term results of TEVAR with intentional CA coverage for C-I TAAA. METHODS: Between August 2010 and July 2017, we treated 16 cases of C-I TAAA by TEVAR with intentional CA coverage using the Zenith TX2 Thoracic Distal Component Endograft. The primary end point was aneurysm shrinkage. Secondary end points were technical success, aneurysm-related death (ARD), and major adverse events (MAEs) including stroke, paraplegia, visceral ischemia, endoleak, and secondary intervention. RESULTS: The preoperative mean aneurysm size was 57.7 ± 8.0 mm. The technical success rate was 100%. There was no aneurysm-related mortality; however, one patient suffered from superior mesenteric artery embolization, which required an open laparotomy. The mean observational period was 40.5 months, and aneurysm shrinkage of >5 mm was observed in 10 cases (62.5%). At 12, 36, and 60 months after the procedure, freedom from ARD was 100%, 100%, and 100%, respectively, whereas freedom from MAE including secondary intervention was 86.7%, 86.7%, and 77.0%, respectively. CONCLUSIONS: Mid-term results of TEVAR with intentional CA coverage for C-I TAAA were acceptable.
BACKGROUND: Anatomically suitable Crawford type I (C-I) thoracoabdominal aortic aneurysm (TAAA) can be treated by thoracic endovascular aneurysm repair (TEVAR) with intentional celiac artery (CA) coverage to ensure distal seal. We report on mid-term results of TEVAR with intentional CA coverage for C-I TAAA. METHODS: Between August 2010 and July 2017, we treated 16 cases of C-I TAAA by TEVAR with intentional CA coverage using the Zenith TX2 Thoracic Distal Component Endograft. The primary end point was aneurysm shrinkage. Secondary end points were technical success, aneurysm-related death (ARD), and major adverse events (MAEs) including stroke, paraplegia, visceral ischemia, endoleak, and secondary intervention. RESULTS: The preoperative mean aneurysm size was 57.7 ± 8.0 mm. The technical success rate was 100%. There was no aneurysm-related mortality; however, one patient suffered from superior mesenteric artery embolization, which required an open laparotomy. The mean observational period was 40.5 months, and aneurysm shrinkage of >5 mm was observed in 10 cases (62.5%). At 12, 36, and 60 months after the procedure, freedom from ARD was 100%, 100%, and 100%, respectively, whereas freedom from MAE including secondary intervention was 86.7%, 86.7%, and 77.0%, respectively. CONCLUSIONS: Mid-term results of TEVAR with intentional CA coverage for C-I TAAA were acceptable.