Universität zu Köln

Moulakakis, Konstantinos G., Mylonas, Spyridon N., Avgerinos, Efthimios D., Kakisis, John D., Brunkwall, Jan and Liapis, Christos D. (2011). Hybrid Open Endovascular Technique for Aortic Thoracoabdominal Pathologies. Circulation, 124 (24). S. 2670 - 2683. PHILADELPHIA: LIPPINCOTT WILLIAMS & WILKINS. ISSN 1524-4539

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Abstract

Background-Many authors using a hybrid debranching strategy for the treatment of thoracoabdominal pathologies have reported disappointing results and the initial enthusiasm for the technique has given way to criticism and ambiguity. The aim of the present meta-analysis study was to assess the safety and efficacy of the technique in patients with thoracoabdominal aortic aneurysms or other aortic pathologies. Methods and Results-A multiple electronic search was performed on all articles describing hybrid open endovascular repair. Separate meta-analyses were conducted for technical success, visceral graft patency, spinal cord ischemia symptoms, renal insufficiency, and other complications as well as 30-day/in-hospital mortality. Nineteen publications with a total of 507 patients were analyzed. The pooled estimates for primary technical success and visceral graft patency were 96.2% (95% CI, 93.5%-98.2%) and 96.5% (95% CI, 95.2%-97.8%) respectively. A pooled rate of 7.5% (95% CI, 5.0%-11.0%) for overall spinal cord ischemia symptoms was observed; whereas for irreversible paraplegia the pooled rate was 4.5% (95% CI, 2.5%-7.0%). The pooled estimate for renal failure was 8.8% (95% CI, 3.9%-15.5%). The pooled 30-day/in-hospital mortality rate was 12.8% (95% CI, 8.6%-17.0%). During the mean follow-up period of 34.5 (95% CI, 31.5-37.5) months, a total of 119 endoleaks were identified in 111 patients (22.7%). Conclusions-The repair of thoracoabdominal pathologies by means of hybrid procedures in patients who are poor surgical candidates is still associated with significant morbidity and mortality rates. Future studies may substantiate whether the technique is amenable to amelioration and improvement. (Circulation. 2011;124:2670-2680.)

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Moulakakis, Konstantinos G. UNSPECIFIED UNSPECIFIED UNSPECIFIED Mylonas, Spyridon N. UNSPECIFIED UNSPECIFIED UNSPECIFIED Avgerinos, Efthimios D. UNSPECIFIED UNSPECIFIED UNSPECIFIED Kakisis, John D. UNSPECIFIED UNSPECIFIED UNSPECIFIED Brunkwall, Jan UNSPECIFIED UNSPECIFIED UNSPECIFIED Liapis, Christos D. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-483530
DOI:	10.1161/CIRCULATIONAHA.111.041582
Journal or Publication Title:	Circulation
Volume:	124
Number:	24
Page Range:	S. 2670 - 2683
Date:	2011
Publisher:	LIPPINCOTT WILLIAMS & WILKINS
Place of Publication:	PHILADELPHIA
ISSN:	1524-4539
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language STENT-GRAFT REPAIR; ANEURYSM REPAIR; EXPERIENCE Multiple languages Cardiac & Cardiovascular Systems; Peripheral Vascular Disease Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/48353