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Aortic arch debranching and thoracic endovascular repair

Tuesday, January 14, 2014

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Source Name: Journal of Vascular Surgery


Paola De Rango, Piergiorgio Cao, Ciro Ferrer, Gioele Simonte, Carlo Coscarella, Enrico Cieri, Gabriele Pogany, Fabio Verzini et al.

The authors reviewed their experience with 104 consecutive patients who underwent elective arch treatment with debranching and thoracic endovascular aortic repair between 2005-2013.  Major complications at 30 days (death, stroke, and spinal cord ischemia) occurred in 6, 4, and 3 patients, respectively. At 1, 3, and 5 years survival rates were 89.0%, 82.8%, and 70.9%. Extension to ascending aorta (zone 0 landing) was the only multivariate independent predictor for perioperative mortality. Freedom from persistent endoleak was 96.1%, 92.5%, and 88.3% at 1,3, and 5 years. The authors conclude that the endovascular aortic arch repair presents a low rate of aorta-related deaths and reinterventions and acceptable midterm survival.  One-third of the aneurysms decreased in diameter over 5 years. Retrograde type A dissection remains a major concern in the perioperative period.

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