Universität zu Köln

Ahmad, Wael ORCID: 0000-0001-5090-3468, Mylonas, Spyridon ORCID: 0000-0002-9875-4614, Majd, Payman and Brunkwall, Jan Sigge (2017). A current systematic evaluation and meta-analysis of chimney graft technology in aortic arch diseases. J. Vasc. Surg., 66 (5). S. 1602 - 1613. NEW YORK: MOSBY-ELSEVIER. ISSN 0741-5214

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Abstract

Objective: The aim of this study was to provide a review of the literature on the use of chimney graft (CG) technique in treating arterial diseases of the aortic arch and to extrapolate conclusions by summarizing the reported outcomes in a meta-analysis. Methods: An extensive electronic search was made using PubMed/MEDLINE, Science Direct Databases, and the Cochrane Library. Included in this meta-analysis were all papers published up to February 2016 on endovascular chimney technique in the arch vessels with or without adjunct extra-anatomic debranching, in any language, providing data about at least one of the essential outcomes: early and late type I endoleak, 30-day mortality rate, development of perioperative stroke, patency, and retrograde aortic dissection. Results: Of the 478 reports yielded by the electronic search, a total of 11 publications (on 373 patients and 387 CGs) fulfilled the inclusion criteria and were included in this study. The overall estimated proportion of technical success was 91.3% (95% confidence interval [CI], 87.4%-94.0%). Of the 373 patients, 26 (7%) experienced a type Ia endoleak in the perioperative period. The overall estimated proportion of early type Ia endoleak was 9.4% (95% CI, 6.5%-13.4%). Among the 10 studies that provided data, a retrograde type A dissection was observed in 2 of 351 patients, resulting in an overall estimated proportion of 1.8% (95% CI, 0.8%-4.0%). The pooled 30-day mortality rate was 7.9% (95% CI, 4.6%-13.2%). The pooled estimation for reintervention was 10.6% (95% CI, 5%-21%); for major stroke, 2.6% (95% CI, 1.3%-5.0%); for early patency, 97.9% (95% CI, 95.8%-99%); and for late patency, 92.9% (95% CI, 87.3%-96%). Conclusions: Treatment of aortic diseases involving the aortic arch poses a great challenge. The CG technique has been applied as an alternative treatment option. This meta-analysis shows that endovascular repair of aortic arch disease using a CG technique in the aortic arch vessels is technically feasible and effective but not without major risk of complications.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Ahmad, Wael UNSPECIFIED orcid.org/0000-0001-5090-3468 UNSPECIFIED Mylonas, Spyridon UNSPECIFIED orcid.org/0000-0002-9875-4614 UNSPECIFIED Majd, Payman UNSPECIFIED UNSPECIFIED UNSPECIFIED Brunkwall, Jan Sigge UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-212353
DOI:	10.1016/j.jvs.2017.06.100
Journal or Publication Title:	J. Vasc. Surg.
Volume:	66
Number:	5
Page Range:	S. 1602 - 1613
Date:	2017
Publisher:	MOSBY-ELSEVIER
Place of Publication:	NEW YORK
ISSN:	0741-5214
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language EUROPEAN MULTICENTER REGISTRY; ENDOVASCULAR REPAIR; ZONE 0; HYBRID ARCH; HEALTH-CARE; DISSECTION; EXPERIENCE; BRANCHES; TEVAR; PRESERVATION Multiple languages Surgery; Peripheral Vascular Disease Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/21235