Outcomes of Elective and Non-elective Fenestrated-branched Endovascular Aortic Repair for Treatment of Thoracoabdominal Aortic Aneurysms

被引：23

作者：

Dias-Neto, Marina ^{[1
]}

Vacirca, Andrea ^{[1
]}

Huang, Ying ^{[1
]}

Baghbani-Oskouei, Aidin ^{[1
]}

Jakimowicz, Tomasz ^{[2
]}

Mendes, Bernardo C. ^{[3
]}

Kolbel, Tilo ^{[4
]}

Sobocinski, Jonathan ^{[5
,6
]}

Bertoglio, Luca ^{[7
,8
]}

Mees, Barend ^{[9
]}

Gargiulo, Mauro ^{[10
,11
]}

Dias, Nuno ^{[12
,13
]}

Schanzer, Andres ^{[14
]}

Gasper, Warren ^{[15
]}

Beck, Adam W. ^{[16
]}

Farber, Mark A. ^{[17
]}

Mani, Kevin ^{[18
]}

Timaran, Carlos ^{[19
]}

Schneider, Darren B. ^{[20
]}

Pedro, Luis Mendes ^{[21
,22
,23
]}

Tsilimparis, Nikolaos ^{[24
]}

Haulon, Stephan ^{[25
]}

Sweet, Matthew P. ^{[26
]}

Ferreira, Emilia ^{[27
]}

Eagleton, Matthew ^{[28
]}

Yeung, Kak Khee ^{[29
]}

Khashram, Manar ^{[30
,31
]}

Jama, Katarzyna ^{[2
]}

Panuccio, Giuseppe ^{[4
]}

Rohlffs, Fiona ^{[4
]}

Mesnard, Thomas ^{[5
,6
]}

Chiesa, Roberto ^{[7
,8
]}

Kahlberg, Andrea ^{[7
,8
]}

Schurink, Geert Willem ^{[9
]}

Lemmens, Charlotte ^{[9
]}

Gallitto, Enrico ^{[10
,11
]}

Faggioli, Gianluca ^{[10
,11
]}

Karelis, Angelos ^{[12
,13
]}

Parodi, Ezequiel ^{[17
]}

Gomes, Vivian ^{[17
]}

Wanhainen, Anders ^{[18
]}

Habib, Mohammed ^{[18
]}

Colon, Jesus Porras ^{[19
]}

Pavarino, Felipe ^{[19
]}

Baig, Mirza S. ^{[19
]}

Melo, Ryan Eduardo Costeloe De ^{[21
,22
,23
,24
]}

Crawford, Sean ^{[25
]}

Zettervall, Sara L. ^{[26
]}

Garcia, Rita ^{[27
]}

Ribeiro, Tiago ^{[27
]}

机构：

[1] Univ Texas Hlth Sci Ctr Houston, McGovern Med Sch, Adv Aort Res Program, Dept Cardiothorac & Vasc Surg, Houston, TX 77030 USA

[2] Med Univ Warsaw, Warsaw, Poland

[3] Mayo Clin, Div Vasc & Endovasc Surg, Rochester, MN USA

[4] Univ Med Ctr Eppendorf UKE, Hamburg, Germany

[5] Univ Lille, CHU Lille, Aort Ctr, Vasc Surg, Lille, France

[6] Univ Lille, CHU Lille, INSERM U1008, Lille, France

[7] Univ Vita Salute San Raffaele, San Raffaele Sci Inst, Dept Vasc Surg, Milan, Italy

[8] Univ & ASST Spedali Civili Hosp Brescia, Dept Sperimental & Clin Sci DSCS, Brescia, Italy

[9] Maastricht Univ, Med Ctr, Dept Vasc Surg, Maastricht, Netherlands

[10] Univ Bologna, Vasc Surg, DIMEC, Bologna, Italy

[11] IRCCS Univ Hosp Policlin S Orsola, Vasc Surg Unit, Bologna, Italy

[12] Skane Univ Hosp, Vasc Ctr, Dept Thorac Surg & Vasc Dis, Malmo, Sweden

[13] Lund Univ, Dept Clin Sci, Malmo, Sweden

[14] Univ Massachusetts, Med Sch, Worcester, MA USA

[15] Univ Calif San Francisco, San Francisco, CA USA

[16] Univ Alabama Birmingham, Birmingham, AL USA

[17] Univ N Carolina, Dept Surg, Div Vasc Surg, Chapel Hill, NC USA

[18] Uppsala Univ, Dept Surg Sci, Div Vasc Surg, Uppsala, Sweden

[19] Univ Texas Southwestern, Clin Heart & Vasc Ctr, Dallas, TX USA

[20] Univ Penn, Perelman Sch Med, Div Vasc Surg & Endovasc Therapy, Philadelphia, PA USA

[21] Ctr Hosp Univ Lisboa Norte, Dept Vasc Surg, Lisbon, Portugal

[22] Univ Lisbon, Fac Med, Lisbon, Portugal

[23] Univ Lisboa CCULRISE, Ctr Cardiovasc, Lisbon, Portugal

[24] Ludwig Maximilians Univ Hosp, Dept Vasc Surg, Munich, Germany

[25] Univ Paris Saclay, Hop Marie Lannelongue, Aort Ctr, Grp Hosp Paris St Joseph, Paris, France

[26] Univ Washington, Dept Surg, Div Vasc Surg, Seattle, WA USA

[27] Ctr Hosp Univ Lisboa Cent, Hosp Santa Marta, Dept Angiol & Vasc Surg, Lisbon, Portugal

[28] Harvard Med Sch, Massachusetts Gen Hosp, Div Vasc & Endovasc Surg, Boston, MA USA

[29] Amsterdam UMC, VU Med Ctr, Amsterdam Cardiovasc Sci, Dept Vasc Surg, Amsterdam, Netherlands

[30] Waikato Hosp, Dept Vasc Surg, Hamilton, New Zealand

[31] Univ Auckland, Dept Surg, Auckland, New Zealand

来源：

ANNALS OF SURGERY | 2023年 / 278卷 / 04期

关键词：

fenestrated-branched endovascular aortic repair; thoracoabdominal aortic aneurysm; non-elective repair; elective repair; MIDTERM OUTCOMES; ENDOGRAFTS; MORTALITY;

D O I：

10.1097/SLA.0000000000005986

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

Objective: To describe outcomes after elective and non-elective fenestrated-branched endovascular aortic repair (FB-EVAR) for thoracoabdominal aortic aneurysms (TAAAs). Background: FB-EVAR has been increasingly utilized to treat TAAAs; however, outcomes after non-elective versus elective repair are not well described. Methods: Clinical data of consecutive patients undergoing FB-EVAR for TAAAs at 24 centers (2006-2021) were reviewed. Endpoints including early mortality and major adverse events (MAEs), all-cause mortality, and aortic-related mortality (ARM), were analyzed and compared in patients who had non-elective versus elective repair. Results: A total of 2603 patients (69% males; mean age 72 +/- 10 year old) underwent FB-EVAR for TAAAs. Elective repair was performed in 2187 patients (84%) and non-elective repair in 416 patients [16%; 268 (64%) symptomatic, 148 (36%) ruptured]. Non-elective FB-EVAR was associated with higher early mortality (17% vs 5%, P < 0.001) and rates of MAEs (34% vs 20%, P < 0.001). Median follow-up was 15 months ( interquartile range, 7-37 months). Survival and cumulative incidence of ARM at 3 years were both lower for non-elective versus elective patients (50 +/- 4% vs 70 +/- 1% and 21 +/- 3% vs 7 +/- 1%, P < 0.001). On multivariable analysis, non-elective repair was associated with increased risk of all-cause mortality ( hazard ratio, 1.92; 95% CI] 1.50-2.44; P < 0.001) and ARM (hazard ratio, 2.43; 95% CI, 1.63-3.62; P < 0.001). Conclusions: Non-elective FB-EVAR of symptomatic or ruptured TAAAs is feasible, but carries higher incidence of early MAEs and increased all-cause mortality and ARM than elective repair. Long-term follow-up is warranted to justify the treatment.

引用

页码：568 / 577

页数：10

共 22 条

[1] Editor's Choice - The Impact of Centralisation and Endovascular Aneurysm Repair on Treatment of Ruptured Abdominal Aortic Aneurysms Based on International Registries [J].

Budtz-Lilly, Jacob ;

Bjorck, Martin ;

Venermo, Maarit ;

Debus, Sebastian ;

Behrendt, Christian-Alexander ;

Altreuther, Martin ;

Beiles, Barry ;

Szeberin, Zoltan ;

Eldrup, Nikolaj ;

Danielsson, Gudmundur ;

Thomson, Ian ;

Wigger, Pius ;

Khashram, Manar ;

Loftus, Ian ;

Mani, Kevin .

EUROPEAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY, 2018, 56 (02) :181-188

[2] Comparison of upper extremity and transfemoral access for fenestrated-branched endovascular aortic repair [J].

Chamseddin, Khalil ;

Timaran, Carlos H. ;

Oderich, Gustavo S. ;

Tenorio, Emanuel R. ;

Farber, Mark A. ;

Parodi, Ezequiel F. ;

Schneider, Darren B. ;

Schanzer, Andres ;

Beck, Adam W. ;

Sweet, Matthew P. ;

Zettervall, Sara L. ;

Mendes, Bernardo ;

Eagleton, Matthew J. ;

Gasper, Warren J. .

JOURNAL OF VASCULAR SURGERY, 2023, 77 (03) :704-711

[3] Outcomes of 3309 thoracoabdominal aortic aneurysm repairs [J].

Coselli, Joseph S. ;

LeMaire, Scott A. ;

Preventza, Ourania ;

de la Cruz, Kim I. ;

Cooley, Denton A. ;

Price, Matt D. ;

Stolz, Alan P. ;

Green, Susan Y. ;

Arredondo, Courtney N. ;

Rosengart, Todd K. .

JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 2016, 151 (05) :1323-1337

[4] RUPTURED ANEURYSM OF THE DESCENDING THORACIC AND THORACOABDOMINAL AORTA - ANALYSIS ACCORDING TO SIZE AND TREATMENT [J].

CRAWFORD, ES ;

HESS, KR ;

COHEN, ES ;

COSELLI, JS ;

SAFI, HJ .

ANNALS OF SURGERY, 1991, 213 (05) :417-426

[5] Comparison of single- and multistage strategies during fenestrated-branched endovascular aortic repair of thoracoabdominal aortic aneurysms [J].

Dias-Neto, Marina ;

Tenorio, Emanuel R. ;

Huang, Ying ;

Jakimowicz, Tomasz ;

Mendes, Bernardo C. ;

Koelbel, Tilo ;

Sobocinski, Jonathan ;

Bertoglio, Luca ;

Mees, Barend ;

Gargiulo, Mauro ;

Dias, Nuno ;

Schanzer, Andres ;

Gasper, Warren ;

Beck, Adam W. ;

Farber, Mark A. ;

Mani, Kevin ;

Timaran, Carlos ;

Schneider, Darren B. ;

Pedro, Luis Mendes ;

Tsilimparis, Nikolaos ;

Haulon, Stephan ;

Sweet, Matt ;

Ferreira, Emilia ;

Eagleton, Matthew ;

Yeung, Kak Khee ;

Khashram, Manar ;

Vacirca, Andrea ;

Lima, Guilherme B. ;

Baghbani-Oskouei, Aidin ;

Jama, Katarzyna ;

Panuccio, Giuseppe ;

Rohlffs, Fiona ;

Chiesa, Roberto ;

Schurink, Geert Willem ;

Lemmens, Charlotte ;

Gallitto, Enrico ;

Faggioli, Gianluca ;

Karelis, Angelos ;

Parodi, Ezequiel ;

Gomes, Vivian ;

Wanhainen, Anders ;

Dean, Anastasia ;

Colon, Jesus Porras ;

Pavarino, Felipe ;

Melo, Ryan Gouveia e ;

Crawford, Sean ;

Garcia, Rita ;

Ribeiro, Tiago ;

Kappe, Kaj Olav ;

van Knippenberg, Samira Elize Mariko .

JOURNAL OF VASCULAR SURGERY, 2023, 77 (06)

[6] Fenestrated endovascular aortic aneurysm repair using physician-modified endovascular grafts versus company-manufactured devices [J].

Dossabhoy, Shernaz S. ;

Simons, Jessica P. ;

Flahive, Julie M. ;

Aiello, Francesco A. ;

Sheth, Parth ;

Arous, Edward J. ;

Messina, Louis M. ;

Schanzer, Andres .

JOURNAL OF VASCULAR SURGERY, 2018, 67 (06) :1673-1683

[7] Urgent endovascular repair of thoracoabdominal aneurysms using an off-the-shelf multibranched endograft [J].

Gallitto, Enrico ;

Faggioli, Gianluca ;

Spath, Paolo ;

Pini, Rodolfo ;

Mascoli, Chiara ;

Logiacco, Antonino ;

Gargiulo, Mauro .

EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY, 2022, 61 (05) :1087-1096

[8] Propensity scored analysis of outcomes after ruptured abdominal aortic aneurysm [J].

Holt, P. J. E. ;

Karthikesalingam, A. ;

Poloniecki, J. D. ;

Hinchliffe, R. J. ;

Loftus, I. M. ;

Thompson, M. M. .

BRITISH JOURNAL OF SURGERY, 2010, 97 (04) :496-503

[9] Mid-term Outcomes of Endovascular Repair of Ruptured Thoraco-abdominal Aortic Aneurysms with Off the Shelf Branched Stent Grafts [J].

Hongku, Kiattisak ;

Sonesson, Bjorn ;

Bjorses, Katarina ;

Holst, Jan ;

Resch, Timothy ;

Dias, Nuno, V .

EUROPEAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY, 2018, 55 (03) :377-384

[10] 2022 ACC/AHA Guideline for the Diagnosis and Management of Aortic Disease: A Report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines [J].

Isselbacher, Eric M. ;

Preventza, Ourania ;

Hamilton Black, James ;

Augoustides, John G. ;

Beck, Adam W. ;

Bolen, Michael A. ;

Braverman, Alan C. ;

Bray, Bruce E. ;

Brown-Zimmerman, Maya M. ;

Chen, Edward P. ;

Collins, Tyrone J. ;

DeAnda, Abe ;

Fanola, Christina L. ;

Girardi, Leonard N. ;

Hicks, Caitlin W. ;

Hui, Dawn S. ;

Schuyler Jones, William ;

Kalahasti, Vidyasagar ;

Kim, Karen M. ;

Milewicz, Dianna M. ;

Oderich, Gustavo S. ;

Ogbechie, Laura ;

Promes, Susan B. ;

Gyang Ross, Elsie ;

Schermerhorn, Marc L. ;

Singleton Times, Sabrina ;

Tseng, Elaine E. ;

Wang, Grace J. ;

Woo, Y. Joseph .

CIRCULATION, 2022, 146 (24) :E334-E482

← 1 2 3 →