Laser fenestration of aortic arch stent grafts for endovascular treatment of retrograde type A dissection

被引:10
作者
Qin, Jinbao [1 ]
Wu, Xiaoyu [1 ]
Li, Weimin [1 ]
Ye, Kaichuang [1 ]
Yin, Minyi [1 ]
Liu, Guang [1 ]
Cui, Chaoyi [1 ]
Zhao, Zhen [1 ,2 ]
Liu, Xiaobing [1 ,2 ]
Lu, Xinwu [1 ,2 ]
机构
[1] Shanghai Jiao Tong Univ, Shanghai Peoples Hosp 9, Sch Med, Dept Vasc Surg, Shanghai 200011, Peoples R China
[2] Shanghai Jiao Tong Univ, Vasc Ctr, Shanghai 200011, Peoples R China
基金
中国国家自然科学基金; 上海市自然科学基金;
关键词
Retrograde type a dissection; in situ stent grafts fenestration; Laser; Arch branch artery; Thoracic endovascular aortic repair; INTRAMURAL HEMATOMA; REPAIR; OUTCOMES; UNFIT;
D O I
10.1016/j.ijcard.2020.12.011
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objectives: Retrograde type A dissection (RTAD) is a rare but life-threatening event following thoracic endovascular aortic repair (TEVAR), and its total endovascular treatment is a huge challenge. This research aimed to evaluate the safety, effectiveness, technical success, and medical outcomes of in situ laser fenestration of aortic arch stent grafts during TEVAR of RTAD. Methods: We retrospectively reviewed the clinical data of 15 patients with RTAD who received in situ laser fenestration of aortic arch stent grafts during TEVAR between Mar 2016 and Dec 2019. All patients were subjected to intraoperative extracorporeal brain perfusion. The preoperative, intraoperative and postoperative medical data were collected and analyzed. Results: The mean age of the 15 patients was 64 8 years, 8 of whom were male. The immediate overall technical success rates, including aortic stent deployment were 100% and primary fenestration success was achieved in 13 (86.7%) patients. The mean postoperative length of stay was 10 4 days. Stroke occurred in 1 case. No inhospital/30-day death nor permanent paraplegia/paresis was observed. The mean follow-up time was 13 +/- 5 months. Two type Ia endoleaks were found, but no late occlusion and migration of the supra-aortic branch arteries stents during the follow-up were observed. Conclusions: The in situ laser fenestration of aortic arch stent grafts during TEVAR of RTAD is a potential total endovascular therapy of RTAD for patients unsuitable for direct surgical repair. (c) 2020 Published by Elsevier B.V.
引用
收藏
页码:69 / 74
页数:6
相关论文
共 28 条
[1]   Influence of Primary Intimal Tear Location in Type B Aortic Dissection as a Factor Portending Retrograde Type A Aortic Dissection after Endovascular Repair [J].
Al-kalei, Adel Mohammed Amer ;
Wu, Ziheng ;
Zhang, Hongkun .
JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY, 2018, 29 (06) :833-840
[2]   Retrograde Type A Dissection after Ascending Aorta Involved Endovascular Repair and Its Surgical Repair with Stented Elephant Trunk [J].
An, Zhao ;
Tan, Meng-Wei ;
Song, Zhi-Gang ;
Tang, Hao ;
Lu, Fang-Lin ;
Xu, Zhi-Yun .
ANNALS OF VASCULAR SURGERY, 2019, 58 :198-+
[3]   Retrograde Type A Dissection after Thoracic Endovascular Aortic Repair: Surgical Strategy and Literature Review [J].
An, Zhao ;
Song, Zhigang ;
Tang, Hao ;
Han, Lin ;
Xu, Zhiyun .
HEART LUNG AND CIRCULATION, 2018, 27 (05) :629-634
[4]   Aortic disease: thoracic endovascular aortic repair [J].
Bicknell, Colin ;
Powell, Janet T. .
HEART, 2015, 101 (08) :586-591
[5]   Factors Favoring Retrograde Type A Aortic Dissection After Endovascular Aortic Repair [J].
Canaud, Ludovic ;
Sfeir, Julien ;
Alric, Pierre ;
Bommart, Sebastien .
ANNALS OF THORACIC SURGERY, 2018, 105 (02) :668-668
[6]   Chimney parallel grafts and thoracic endovascular aortic repair for blunt traumatic thoracic aortic injuries: A systematic review [J].
Carter, Rebeca ;
Yan, Ian Wee Jun ;
Petrie, Kyle ;
Syn, Nicholas ;
Choong, Andrew M. T. L. .
VASCULAR, 2019, 27 (02) :204-212
[7]   Retrograde Type A Aortic Dissection After Thoracic Endovascular Aortic Repair: A Systematic Review and Meta-Analysis [J].
Chen, Yanqing ;
Zhang, Simeng ;
Liu, Lei ;
Lu, Qingsheng ;
Zhang, Tianyi ;
Jing, Zaiping .
JOURNAL OF THE AMERICAN HEART ASSOCIATION, 2017, 6 (09)
[8]   Retrograde Ascending Aortic Dissection During or After Thoracic Aortic Stent Graft Placement Insight From the European Registry on Endovascular Aortic Repair Complications [J].
Eggebrecht, Holger ;
Thompson, Matt ;
Rousseau, Herve ;
Czerny, Martin ;
Loenn, Lars ;
Mehta, Rajendra H. ;
Erbel, Raimund .
CIRCULATION, 2009, 120 (11) :S276-S281
[9]   Endovascular repair of aortic arch disease with double inner branched thoracic stent graft: the Bolton perspective [J].
Ferrer, Ciro ;
Coscarella, Carlo ;
Cao, Piergiorgio .
JOURNAL OF CARDIOVASCULAR SURGERY, 2018, 59 (04) :547-553
[10]   Thoracic endovascular aortic repair for retrograde type A aortic dissection [J].
Higashigawa, Takatoshi ;
Kato, Noriyuki ;
Nakajima, Ken ;
Chino, Shuji ;
Hashimoto, Takashi ;
Ouchi, Takafumi ;
Tokui, Toshiya ;
Maze, Yasumi ;
Mizumoto, Toru ;
Teranishi, Satoshi ;
Yamamto, Naoki ;
Ito, Hisato ;
Sakuma, Hajime .
JOURNAL OF VASCULAR SURGERY, 2019, 69 (06) :1685-1693