OBJECTIVES: The aim of this study was to report the outcomes of open or hybrid repair of failed thoraco-abdominal aortic aneurysm endovascular treatment with Multilayer Flow Modulator (MFM) stents. METHODS: All patients who underwent open or hybrid repair of a failed MFM aortic treatment were retrospectively analysed. Perioperative and postoperative data, as well as midterm survival, were assessed. RESULTS: Between 2013 and 2020, 39 patients received an open or hybrid conversion after endovascular treatment. Five of them [13%; 4 males; median age 68 years (interquartile range 66-76)] were previously treated with aortic MFM stents (Cardiatis, Isnes, Belgium). Among these, the median interval between index repair and conversion was 84 months (interquartile range 75-84). The median aneurysm diameter was 9.6 cm (interquartile range 8-10). Renovisceral vessels steno-occlusion was highly prevalent: 2 renal arteries were occluded; 3 coeliac trunks, 2 renal arteries and 1 superior mesenteric artery had a >70% ostial stenosis. Open standard thoraco-abdominal aneurysm conversion was performed in 3 fit patients, while a hybrid approach with visceral debranching and tube endografting was performed in 2 high-risk patients. Two patients (2 open repairs) died intraoperatively, and 1 (hybrid repair) postoperatively. The 2 successfully treated patients are alive at 4- and 34-month follow-up, respectively, with patent visceral branches. CONCLUSIONS: Open or hybrid thoraco-abdominal aortic aneurysm treatment after failed endovascular aortic repair with MFM stents might be the only surgical option to address sac enlargements and ruptures or branch-related failures. However, both procedures had a poor prognosis due to both the impaired preoperative patient's status and the surgical complexity in the presented series.
OBJECTIVES: The aim of this study was to report the outcomes of open or hybrid repair of failed thoraco-abdominal aortic aneurysm endovascular treatment with Multilayer Flow Modulator (MFM) stents. METHODS: All patients who underwent open or hybrid repair of a failed MFM aortic treatment were retrospectively analysed. Perioperative and postoperative data, as well as midterm survival, were assessed. RESULTS: Between 2013 and 2020, 39 patients received an open or hybrid conversion after endovascular treatment. Five of them [13%; 4 males; median age 68 years (interquartile range 66-76)] were previously treated with aortic MFM stents (Cardiatis, Isnes, Belgium). Among these, the median interval between index repair and conversion was 84 months (interquartile range 75-84). The median aneurysm diameter was 9.6 cm (interquartile range 8-10). Renovisceral vessels steno-occlusion was highly prevalent: 2 renal arteries were occluded; 3 coeliac trunks, 2 renal arteries and 1 superior mesenteric artery had a >70% ostial stenosis. Open standard thoraco-abdominal aneurysm conversion was performed in 3 fit patients, while a hybrid approach with visceral debranching and tube endografting was performed in 2 high-risk patients. Two patients (2 open repairs) died intraoperatively, and 1 (hybrid repair) postoperatively. The 2 successfully treated patients are alive at 4- and 34-month follow-up, respectively, with patent visceral branches. CONCLUSIONS: Open or hybrid thoraco-abdominal aortic aneurysm treatment after failed endovascular aortic repair with MFM stents might be the only surgical option to address sac enlargements and ruptures or branch-related failures. However, both procedures had a poor prognosis due to both the impaired preoperative patient's status and the surgical complexity in the presented series.
Authors: Elliot L Chaikof; Jan D Blankensteijn; Peter L Harris; Geoffrey H White; Christopher K Zarins; Victor M Bernhard; Jon S Matsumura; James May; Frank J Veith; Mark F Fillinger; Robert B Rutherford; K Craig Kent Journal: J Vasc Surg Date: 2002-05 Impact factor: 4.268
Authors: M Pieri; P Nardelli; M De Luca; G Landoni; S Frassoni; G Melissano; A Zangrillo; R Chiesa; F Monaco Journal: Eur J Vasc Endovasc Surg Date: 2017-01-06 Impact factor: 7.069
Authors: V Riambau; D Böckler; J Brunkwall; P Cao; R Chiesa; G Coppi; M Czerny; G Fraedrich; S Haulon; M J Jacobs; M L Lachat; F L Moll; C Setacci; P R Taylor; M Thompson; S Trimarchi; H J Verhagen; E L Verhoeven; P Kolh; G J de Borst; N Chakfé; E S Debus; R J Hinchliffe; S Kakkos; I Koncar; J S Lindholt; M Vega de Ceniga; F Vermassen; F Verzini; P Kolh; J H Black; R Busund; M Björck; M Dake; F Dick; H Eggebrecht; A Evangelista; M Grabenwöger; R Milner; A R Naylor; J-B Ricco; H Rousseau; J Schmidli Journal: Eur J Vasc Endovasc Surg Date: 2017-01 Impact factor: 7.069
Authors: Claude D Vaislic; Jean Noël Fabiani; Sidney Chocron; Jacques Robin; Victor S Costache; Jean-Pierre Villemot; Jean Marc Alsac; Pascal N Leprince; Thierry Unterseeh; Eric Portocarrero; Yves Glock; Hervé Rousseau Journal: J Endovasc Ther Date: 2014-02 Impact factor: 3.487