Universität zu Köln

Boeckler, D., Brunkwall, J., Taylor, P. R., Mangialardi, N., Huesing, J. and Larzon, T. (2016). Thoracic Endovascular Aortic Repair of Aortic Arch Pathologies with the Conformable Thoracic Aortic Graft: Early and 2 year Results from a European Multicentre Registry. Eur. J. Vasc. Endovasc. Surg., 51 (6). S. 791 - 801. LONDON: W B SAUNDERS CO LTD. ISSN 1532-2165

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Abstract

Objective: To assess safety, effectiveness and clinical outcome of the conformable thoracic aortic endograft (CTAG) in the treatment of aortic arch pathologies. Methods: Between October 2009 and December 2010, 100 consecutive patients (65 men; mean age 65 years) with aortic arch pathologies were treated with the CTAG device in five European centres. Indications were thoracic aortic aneurysm (n = 57), Type B dissection (n = 24), intramural haematoma (n = 4), penetrating aortic ulcer (n = 9), and traumatic transection (n = 6). Emergency procedures were performed in 33%.The proximal landing zone (LZ) was LZ 0 in 7%, LZ 1 in14%, LZ 2 in 43%, and LZ 3 in 36%. Data were collected prospectively and analysed for technical and clinical success. Conformability and deployment accuracy were analysed on intra-operative angiography and postoperative computed tomography. Mean follow up was 24 +/- 19 months (range, 0.3-36 months). Results: The 30 day, 1 and 2 year survival rates were 90%, 81%, and 74% respectively. The 2 year survival was 80% in the elective and 62% in the emergency groups (p = .20). The major 30 day complication rate was 34%: primary Type la endoleak affected 1%, retrograde dissection in 1%, and the paraplegia and stroke rates at 30 days were 4% and 11%. Age > 70 years was an independent predictor for mortality and complications. The primary technical success rate was 92%; device deployment was successful in 100% and accurate in 99%. Conformability to the aortic arch was achieved in 95%. Conclusion: The CTAG stent graft shows high deployment accuracy, good conformability, and clinical effectiveness in the treatment of aortic arch pathologies. However, thoracic endovascular aortic repair in the arch is associated with a relatively high stroke rate. Further studies with more patients and longer follow up are needed to evaluate the long-term results. (C) 2016 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Boeckler, D. UNSPECIFIED UNSPECIFIED UNSPECIFIED Brunkwall, J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Taylor, P. R. UNSPECIFIED UNSPECIFIED UNSPECIFIED Mangialardi, N. UNSPECIFIED UNSPECIFIED UNSPECIFIED Huesing, J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Larzon, T. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-274462
DOI:	10.1016/j.ejvs.2016.02.006
Journal or Publication Title:	Eur. J. Vasc. Endovasc. Surg.
Volume:	51
Number:	6
Page Range:	S. 791 - 801
Date:	2016
Publisher:	W B SAUNDERS CO LTD
Place of Publication:	LONDON
ISSN:	1532-2165
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language RISK-FACTORS; PERIOPERATIVE STROKE; ANEURYSM REPAIR; STENT; COMPLICATIONS; DISSECTION; TEVAR; PLACEMENT; DISEASE Multiple languages Surgery; Peripheral Vascular Disease Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/27446