Hybrid endovascular repair for aortic arch pathology

Intermediate outcomes and complications: A Retrospective analysis

Woong Chol Kang, Eak Kyun Shin, Chul Hyun Park, Jin Mo Kang, Young Guk Ko, Donghoon Choi, Young Nam Youn, Won Heum Shim

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Objectives To evaluate the outcomes of hybrid endovascular repair for aortic arch pathology. Methods This study was a retrospective analysis involving patients who underwent hybrid endovascular repair for aortic arch pathologies. Results Twenty-one patients (16 men; mean age, 64.7 ± 16.2 years) with aortic arch pathologies were treated by hybrid endovascular repair. The indications for treatment included increased aneurysm size in 16 cases (71.4%), rupture or impending aneurysmal rupture in 5 cases (23.8%), and rapid growth of aortic dissection (≥10 mm/y) in 1 case (4.8%). Supra-aortic vessel transposition and stent-graft implantation were achieved in all cases. Two types of stent-graft was used, as follows: the Seal thoracic stent-graft in 14 patients (66.7%); and the Valiant stent grafts in 7 patients (33.3%). Perioperative complications affected 5 patients (23.8%), as follows: bleeding (n = 4, 19.0%); stroke (n = 3, 14.3%); renal failure (n = 2, 9.5%); vascular injury (n = 1, 4.8%), and respiratory failure (n = 1, 4.8%). Two patients died within 30 days (9.5%). Technical success was achieved in 15 patients (71.5%). Early endoleaks were noted in 4 patients (19.0%). One patient died during follow-up (mean, 21.3 ± 11.6 months) due to a de novo intramural hematoma. Persistent early endoleaks were noted in 4 patients (19.0%); 2 of the 4 patients were successfully managed with implantation of additional stent-grafts. No late onset endoleaks were noted. The death-free survival and reintervention-free survival rates during follow-up were 85.7% and 90.5%, respectively. Conclusion Hybrid treatment with supra-aortic vessel transposition and endovascular repair may be an option in frail patients in who open procedures is too risky.

Original languageEnglish
Pages (from-to)275-282
Number of pages8
JournalCatheterization and Cardiovascular Interventions
Volume82
Issue number2
DOIs
Publication statusPublished - 2013 Aug 1

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Thoracic Aorta
Pathology
Stents
Endoleak
Transplants
Rupture
Vascular System Injuries
Respiratory Insufficiency
Hematoma
Renal Insufficiency
Aneurysm
Dissection
Thorax
Survival Rate
Stroke
Hemorrhage

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging

Cite this

Kang, Woong Chol ; Shin, Eak Kyun ; Park, Chul Hyun ; Kang, Jin Mo ; Ko, Young Guk ; Choi, Donghoon ; Youn, Young Nam ; Shim, Won Heum. / Hybrid endovascular repair for aortic arch pathology : Intermediate outcomes and complications: A Retrospective analysis. In: Catheterization and Cardiovascular Interventions. 2013 ; Vol. 82, No. 2. pp. 275-282.
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abstract = "Objectives To evaluate the outcomes of hybrid endovascular repair for aortic arch pathology. Methods This study was a retrospective analysis involving patients who underwent hybrid endovascular repair for aortic arch pathologies. Results Twenty-one patients (16 men; mean age, 64.7 ± 16.2 years) with aortic arch pathologies were treated by hybrid endovascular repair. The indications for treatment included increased aneurysm size in 16 cases (71.4{\%}), rupture or impending aneurysmal rupture in 5 cases (23.8{\%}), and rapid growth of aortic dissection (≥10 mm/y) in 1 case (4.8{\%}). Supra-aortic vessel transposition and stent-graft implantation were achieved in all cases. Two types of stent-graft was used, as follows: the Seal thoracic stent-graft in 14 patients (66.7{\%}); and the Valiant stent grafts in 7 patients (33.3{\%}). Perioperative complications affected 5 patients (23.8{\%}), as follows: bleeding (n = 4, 19.0{\%}); stroke (n = 3, 14.3{\%}); renal failure (n = 2, 9.5{\%}); vascular injury (n = 1, 4.8{\%}), and respiratory failure (n = 1, 4.8{\%}). Two patients died within 30 days (9.5{\%}). Technical success was achieved in 15 patients (71.5{\%}). Early endoleaks were noted in 4 patients (19.0{\%}). One patient died during follow-up (mean, 21.3 ± 11.6 months) due to a de novo intramural hematoma. Persistent early endoleaks were noted in 4 patients (19.0{\%}); 2 of the 4 patients were successfully managed with implantation of additional stent-grafts. No late onset endoleaks were noted. The death-free survival and reintervention-free survival rates during follow-up were 85.7{\%} and 90.5{\%}, respectively. Conclusion Hybrid treatment with supra-aortic vessel transposition and endovascular repair may be an option in frail patients in who open procedures is too risky.",
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Hybrid endovascular repair for aortic arch pathology : Intermediate outcomes and complications: A Retrospective analysis. / Kang, Woong Chol; Shin, Eak Kyun; Park, Chul Hyun; Kang, Jin Mo; Ko, Young Guk; Choi, Donghoon; Youn, Young Nam; Shim, Won Heum.

In: Catheterization and Cardiovascular Interventions, Vol. 82, No. 2, 01.08.2013, p. 275-282.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Hybrid endovascular repair for aortic arch pathology

T2 - Intermediate outcomes and complications: A Retrospective analysis

AU - Kang, Woong Chol

AU - Shin, Eak Kyun

AU - Park, Chul Hyun

AU - Kang, Jin Mo

AU - Ko, Young Guk

AU - Choi, Donghoon

AU - Youn, Young Nam

AU - Shim, Won Heum

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N2 - Objectives To evaluate the outcomes of hybrid endovascular repair for aortic arch pathology. Methods This study was a retrospective analysis involving patients who underwent hybrid endovascular repair for aortic arch pathologies. Results Twenty-one patients (16 men; mean age, 64.7 ± 16.2 years) with aortic arch pathologies were treated by hybrid endovascular repair. The indications for treatment included increased aneurysm size in 16 cases (71.4%), rupture or impending aneurysmal rupture in 5 cases (23.8%), and rapid growth of aortic dissection (≥10 mm/y) in 1 case (4.8%). Supra-aortic vessel transposition and stent-graft implantation were achieved in all cases. Two types of stent-graft was used, as follows: the Seal thoracic stent-graft in 14 patients (66.7%); and the Valiant stent grafts in 7 patients (33.3%). Perioperative complications affected 5 patients (23.8%), as follows: bleeding (n = 4, 19.0%); stroke (n = 3, 14.3%); renal failure (n = 2, 9.5%); vascular injury (n = 1, 4.8%), and respiratory failure (n = 1, 4.8%). Two patients died within 30 days (9.5%). Technical success was achieved in 15 patients (71.5%). Early endoleaks were noted in 4 patients (19.0%). One patient died during follow-up (mean, 21.3 ± 11.6 months) due to a de novo intramural hematoma. Persistent early endoleaks were noted in 4 patients (19.0%); 2 of the 4 patients were successfully managed with implantation of additional stent-grafts. No late onset endoleaks were noted. The death-free survival and reintervention-free survival rates during follow-up were 85.7% and 90.5%, respectively. Conclusion Hybrid treatment with supra-aortic vessel transposition and endovascular repair may be an option in frail patients in who open procedures is too risky.

AB - Objectives To evaluate the outcomes of hybrid endovascular repair for aortic arch pathology. Methods This study was a retrospective analysis involving patients who underwent hybrid endovascular repair for aortic arch pathologies. Results Twenty-one patients (16 men; mean age, 64.7 ± 16.2 years) with aortic arch pathologies were treated by hybrid endovascular repair. The indications for treatment included increased aneurysm size in 16 cases (71.4%), rupture or impending aneurysmal rupture in 5 cases (23.8%), and rapid growth of aortic dissection (≥10 mm/y) in 1 case (4.8%). Supra-aortic vessel transposition and stent-graft implantation were achieved in all cases. Two types of stent-graft was used, as follows: the Seal thoracic stent-graft in 14 patients (66.7%); and the Valiant stent grafts in 7 patients (33.3%). Perioperative complications affected 5 patients (23.8%), as follows: bleeding (n = 4, 19.0%); stroke (n = 3, 14.3%); renal failure (n = 2, 9.5%); vascular injury (n = 1, 4.8%), and respiratory failure (n = 1, 4.8%). Two patients died within 30 days (9.5%). Technical success was achieved in 15 patients (71.5%). Early endoleaks were noted in 4 patients (19.0%). One patient died during follow-up (mean, 21.3 ± 11.6 months) due to a de novo intramural hematoma. Persistent early endoleaks were noted in 4 patients (19.0%); 2 of the 4 patients were successfully managed with implantation of additional stent-grafts. No late onset endoleaks were noted. The death-free survival and reintervention-free survival rates during follow-up were 85.7% and 90.5%, respectively. Conclusion Hybrid treatment with supra-aortic vessel transposition and endovascular repair may be an option in frail patients in who open procedures is too risky.

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