Universität zu Köln

Ahmad, Wael ORCID: 0000-0001-5090-3468, Liakopoulos, Oliver J., Mylonas, Spyridon, Wegner, Moritz, Brunkwall, Jan and Dorweiler, Bernhard (2021). Long-Term Outcomes after Thoracic Endovascular Aortic Repair Using Chimney Grafts for Aortic Arch Pathologies: 10 Years of Single-Center Experience. Ann. Vasc. Surg., 72. S. 400 - 409. NEW YORK: ELSEVIER SCIENCE INC. ISSN 1615-5947

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Abstract

Background: This study reports the early- and long-term outcomes of the thoracic endovascular aortic repair using the Chimney-Graft technique (ChTEVAR) for the treatment of aortic arch pathologies. Methods: From January 2010 to December 2019, patients who underwent aortic ChTEVAR technique in our institution were included. Early, mid, and long-term outcomes in this group of patients were evaluated. Patient follow-up data were obtained by imaging follow-up that are routinely performed after 3-6 months following initial surgery and then at yearly intervals. Results: Aortic arch repair with a ChTEVAR was performed in 54 patients. The 30-day mortality was 18.5% (n = 10). All-cause 30-day mortality was higher in the subgroup of patients operated urgently (33% vs. 14%) without a significant difference (P = 0.141). Permanent neurological deficit (PND) was observed in 15% (8/54 patients); stroke in 11% (6/54), and paraplegia 4% (2/54). During follow-up the primary and primary-assisted chimney-graft patency was 96.8% and 97.8%, respectively. The multivariate analysis identified the age >70 years and the aortic diameter as independent risk factors for elevated mortality during the follow-up (P = 0.015 and 0.001, respectively). The PND was an independent predictor for 30-day mortality (P = 0.014, hazard ratio 13.5, 95% confidence interval 1.7-106.6). Conclusions: The ChTEVAR has noninferior results to other open and endovascular aortic arch repair methods with an acceptable long-term survival especially in elective procedures.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Ahmad, Wael UNSPECIFIED orcid.org/0000-0001-5090-3468 UNSPECIFIED Liakopoulos, Oliver J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Mylonas, Spyridon UNSPECIFIED UNSPECIFIED UNSPECIFIED Wegner, Moritz UNSPECIFIED UNSPECIFIED UNSPECIFIED Brunkwall, Jan UNSPECIFIED UNSPECIFIED UNSPECIFIED Dorweiler, Bernhard UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-565682
DOI:	10.1016/j.avsg.2020.08.129
Journal or Publication Title:	Ann. Vasc. Surg.
Volume:	72
Page Range:	S. 400 - 409
Date:	2021
Publisher:	ELSEVIER SCIENCE INC
Place of Publication:	NEW YORK
ISSN:	1615-5947
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language ELEPHANT TRUNK TECHNIQUE; SPINAL-CORD ISCHEMIA; ANEURYSM REPAIR; HYBRID; DISSECTION; GENDER; TEVAR; PLACEMENT; SURVIVAL; EFFICACY Multiple languages Surgery; Peripheral Vascular Disease Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/56568