The Journal of Thoracic and Cardiovascular Surgery
Adult: AortaEndovascular repair of intercostal and visceral aortic patch aneurysms following open thoracoabdominal aortic aneurysm repair
Graphical abstract
Section snippets
Methods
The study was approved by the institutional review board in all centers (19-010702/October 23, 2019). All patients consented for data collection using prospectively maintained databases at each of the 8 international academic centers. The clinical data and outcomes of all consecutive patients treated by F-BEVAR for visceral and intercostal aortic patch aneurysm between March 2011 and October 2019 were analyzed in a retrospective fashion using a standardized database (Table E1 and Figure E1).
Patient Study
A total of 2917 patients were treated by F-BEVAR in the 8 centers during the study period. From this group, 29 patients (1%), 21 men (72%) and 8 women (28%), with a median age of 70 (interquartile range [IQR], 63-74) years old were included in the analysis (Table 1). Indication for treatment of patch aneurysms occurred 9 ± 9 years after the index OSR of TAAA. The most common cardiovascular risk factors were hypertension in 27 patients (93%), hypercholesterolemia in 19 patients (66%), and
Discussion
This multicenter international study outlines the largest series of patients treated for intercostal and visceral aortic patch aneurysms after previous open surgical TAAA repair using F-BEVAR. The observation of high technical success (100%) with no 30-day or in-hospital mortality and low rates of MAEs supports the feasibility of the F-BEVAR for treatment of intercostal and visceral aortic patch aneurysms after previous open surgical TAAA repair. Although the numbers are small, the outcomes
Conclusions
Despite the small number of patients included in this study, it is the largest report of F-BEVAR for visceral or intercostal aortic patch aneurysms. This series showed no mortality and a low rate of MAEs, but a significant need for secondary intervention. Although open repair has traditionally been the first line of treatment in most patients, F-BEVAR could be considered as a viable alternative. Larger clinical experience and longer follow-up are needed to determine indications, results, and to
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Trans-Atlantic Aortic Research Consortium Investigators: Emanuel R. Tenorio, MD, PhD,a,b Gustavo S. Oderich, MD,a Andres Schanzer, MD,c Adam W. Beck, MD,d Mauro Gargiulo, MD,e Mark A. Farber, MD,f Bijan Modarai, MD, PhD,g Tomasz Jakimowicz, MD, PhD,h Luca Bertoglio, MD,i Roberto Chiesa, MD,j Enrico Gallitto, MD, PhD,k Giulianna B. Marcondes, MD,l F. Ezequiel Parodi, MD,m Fernando Motta, MD,m Panos Gkoutzios, MD,n and Katarzyna Jama, MDo; From the aDepartment of Cardiothoracic and Vascular Surgery, University of Texas Health Science Center at Houston, Houston, Tex; bDepartment of Vascular and Endovascular Surgery, Mayo Clinic, Rochester, Minn; cDivision of Vascular Surgery, Department of Surgery, University of Massachusetts Medical School, Worcester, Mass; dDivision of Vascular and Endovascular Surgery, Department of Surgery, University of Alabama at Birmingham, Birmingham, Ala; eVascular Surgery, University of Bologna, University Hospital Policlinico S. Orsola, Bologna, Italy; fDivision of Vascular Surgery, Department of Surgery, University of North Carolina, Chapel Hill, NC; gGuy's and St Thomas' NHS Foundation Trust, King's Health Partners, London, United Kingdom; hDepartment of General, Vascular and Transplant Surgery, Medical University of Warsaw, Warszawa, Poland; and iVita-Salute San Raffaele University, IRCCS San Raffaele Scientific Institute, Milan, Italy.