View in EDS

Total Endovascular Repair of the Aortic Arch: Initial Experience in the Netherlands: Initial Experience in the Netherlands

Saved in:
Bibliographic Details
Title: Total Endovascular Repair of the Aortic Arch: Initial Experience in the Netherlands: Initial Experience in the Netherlands
Authors: van der Weijde, Emma, Heijmen, Robin H., van Schaik, Paul M., Hazenberg, Constantijn E.V.B., van Herwaarden, Joost A.
Contributors: CTC, Zorgeenheid Vaatchirurgie Medisch, Circulatory Health
Source: The Annals of Thoracic Surgery. 109:1858-1863
Publisher Information: Elsevier BV, 2020.
Publication Year: 2020
Subject Terms: Male, Blood Vessel Prosthesis Implantation/methods, Time Factors, FEASIBILITY, Computed Tomography Angiography, Netherlands/epidemiology, Aorta, Thoracic, Prosthesis Design, Blood Vessel Prosthesis Implantation, 03 medical and health sciences, Imaging, Three-Dimensional, 0302 clinical medicine, Risk Factors, Journal Article, Humans, PERIOPERATIVE STROKE, Aorta, Thoracic/diagnostic imaging, Aged, Netherlands, Retrospective Studies, Aged, 80 and over, Aortic Aneurysm, Thoracic, Incidence, Endovascular Procedures, LEFT SUBCLAVIAN ARTERY, Aneurysm, Dissecting/diagnosis, SINGLE-CENTER EXPERIENCE, 3. Good health, Endovascular Procedures/methods, Multicenter Study, Aortic Dissection, Treatment Outcome, Female, Stents, Aortic Aneurysm, Thoracic/diagnosis, Follow-Up Studies
Description: We report procedural and early results in the Netherlands of the Relay Branch device (Terumo Aortic, Sunrise, FL) for total endovascular repair of the aortic arch.Between 2014 and 2018, all consecutive patients who received the Aortic Relay double-branched stent graft in the Netherlands were included in a multicenter, retrospective registry.The Relay Branch device was used in 11 patients to treat saccular (n = 4), fusiform (n = 5), or false aneurysms (n = 2) in the aortic arch. Patients were deemed unfit or extreme high-risk for open (redo) surgery. The brachiocephalic trunk and left common carotid artery were branched using a retrograde approach in all cases. Additional surgical left subclavian artery revascularization was performed in 8 patients. The main device and the branches were successfully introduced, positioned, and deployed with complete exclusion of the aortic pathology in all patients (100% technical success). There was no retrograde type A dissection or conversion to open surgery. Two procedure-related deaths occurred, both caused by perioperative or postoperative strokes. There were 2 minor strokes with full recovery. One patient recovered from transient paraplegia after spinal fluid drainage. No permanent paraplegia was observed. Follow-up imaging showed persistent adequate exclusion of aortic arch pathology. Mean follow-up was 17 months (range, 3-42 months).Total endovascular aortic arch repair using the Relay Branch device is technically feasible and effective in excluding aortic arch pathology. The observed stroke rate in the initial experience, however, was considerable. Although appealing, this new less-invasive technique should be carefully introduced and its progress thoroughly evaluated.
Document Type: Article
File Description: application/pdf
Language: English
ISSN: 0003-4975
DOI: 10.1016/j.athoracsur.2019.09.009
Access URL: http://www.annalsthoracicsurgery.org/article/S0003497519315541/pdf
https://pubmed.ncbi.nlm.nih.gov/31593657
https://www.narcis.nl/publication/RecordID/oai%3Apure.rug.nl%3Apublications%2F1b6f16be-54f8-4d5e-b71e-b8de451aea50
https://www.annalsthoracicsurgery.org/article/S0003-4975(19)31554-1/abstract
https://www.annalsthoracicsurgery.org/article/S0003-4975(19)31554-1/fulltext
https://www.sciencedirect.com/science/article/pii/S0003497519315541
https://www.ncbi.nlm.nih.gov/pubmed/31593657
https://pubmed.ncbi.nlm.nih.gov/31593657/
https://dspace.library.uu.nl/handle/1874/444424
Rights: Elsevier TDM
taverne
Accession Number: edsair.doi.dedup.....f7d6403c7b996d69b1071dfee7cd333d
Database: OpenAIRE
Description
Abstract:We report procedural and early results in the Netherlands of the Relay Branch device (Terumo Aortic, Sunrise, FL) for total endovascular repair of the aortic arch.Between 2014 and 2018, all consecutive patients who received the Aortic Relay double-branched stent graft in the Netherlands were included in a multicenter, retrospective registry.The Relay Branch device was used in 11 patients to treat saccular (n = 4), fusiform (n = 5), or false aneurysms (n = 2) in the aortic arch. Patients were deemed unfit or extreme high-risk for open (redo) surgery. The brachiocephalic trunk and left common carotid artery were branched using a retrograde approach in all cases. Additional surgical left subclavian artery revascularization was performed in 8 patients. The main device and the branches were successfully introduced, positioned, and deployed with complete exclusion of the aortic pathology in all patients (100% technical success). There was no retrograde type A dissection or conversion to open surgery. Two procedure-related deaths occurred, both caused by perioperative or postoperative strokes. There were 2 minor strokes with full recovery. One patient recovered from transient paraplegia after spinal fluid drainage. No permanent paraplegia was observed. Follow-up imaging showed persistent adequate exclusion of aortic arch pathology. Mean follow-up was 17 months (range, 3-42 months).Total endovascular aortic arch repair using the Relay Branch device is technically feasible and effective in excluding aortic arch pathology. The observed stroke rate in the initial experience, however, was considerable. Although appealing, this new less-invasive technique should be carefully introduced and its progress thoroughly evaluated.
ISSN:00034975
DOI:10.1016/j.athoracsur.2019.09.009