Yıl: 2022 Cilt: 28 Sayı: 4 Sayfa Aralığı: 370 - 375 Metin Dili: İngilizce DOI: 10.5152/dir.2022.211293 İndeks Tarihi: 05-10-2022

Outcomes of endovascular treatment of thoracic aorta pathologies: 10-year single-center results

Öz:
PURPOSE Thoracic endovascular aortic repair (TEVAR) is a safe and effective treatment method for a variety of thoracic aortic pathologies. We aimed to investigate the mortality and complication outcomes and associated factors of TEVAR treatment in Turkey. METHODS In this single-centered retrospective study, patients with thoracic aorta pathologies treated with TEVAR at Gazi University School of Medicine, Department of Radiology, between January 2009 and January 2020 were included. Perioperative, early, and late mortality, complications, and technical success were the outcomes. RESULTS The sample comprised 58 patients with 68 TEVAR interventions. Eleven (16.2%) patients were female, the mean age was 60.1 ± 13.4 years. Emergent TEVAR was required in 20.7% of the patients. The main indications of TEVAR were intact descending aorta aneurysms in 37.9% of the sample, 31.0% Stanford type-B dissection, and 12.1% traumatic transections. The techni- cal success rate of primary and secondary interventions was 98.3% and 100%, respectively. The mortality rate in the first 30 days was 8.6%. Seventeen (29.3%) cases had at least 1 complica- tion related to TEVAR treatment. The most common complication was type-1A endoleak (10.3%). Having acute symptoms, stroke, and acute renal failure were significantly associated with mortal- ity (P = .020, .049, and .009, respectively). CONCLUSION This study reported the outcomes of TEVAR treatment from a tertiary medical center in Turkey over a decade. Patients presenting with acute symptoms and who developed stroke and acute renal failure after the procedure should be carefully followed up as these factors were found to be associated with mortality.
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  • 1. Upchurch GR Jr, Escobar GA, Azizzadeh A, et al. Society for Vascular Surgery clinical practice guidelines of thoracic endovascular aortic repair for descending thoracic aortic aneurysms. J Vasc Surg. 2021;73(1S):55S-83S. [CrossRef]
  • 2. Manetta F, Newman J, Mattia A. Indications for thoracic EndoVascular aortic repair (TEVAR): a brief review. Int J Angiol. 2018;27(4):177-184. [CrossRef]
  • 3. Jonker FH, Trimarchi S, Verhagen HJ, Moll FL, Sumpio BE, Muhs BE. Meta-analysis of open versus endovascular repair for ruptured descending thoracic aortic aneurysm. J Vasc Surg. 2010;51(4):1026-1032.e2. [CrossRef]
  • 4. Farber MA, Lee WA, Szeto WY, Panneton JM, Kwolek CJ. Initial and midterm results of the Bolton Relay Thoracic Aortic Endovascular Pivotal Trial. J Vasc Surg. 2017;65(6):1556-1566. e1. [CrossRef]
  • 5. Hellgren T, Wanhainen A, Steuer J, Mani K. Outcome of endovascular repair for intact and ruptured thoracic aortic aneurysms. J Vasc Surg. 2017;66(1):21-28. [CrossRef]
  • 6. Chiu P, Goldstone AB, Schaffer JM, et al. Endovascular versus open repair of intact descending thoracic aortic aneurysms. J Am Coll Cardiol. 2019;73(6):643-651. [CrossRef]
  • 7. Alfson DB, Ham SW. Type B aortic dissections: current guidelines for treatment. Cardiol Clin. 2017;35(3):387-410. [CrossRef]
  • 8. Clough RE, Mani K, Lyons OT, et al. Endovascular treatment of acute aortic syndrome. J Vasc Surg. 2011;54(6):1580-1587. [CrossRef]
  • 9. Orgera G, Tipaldi MA, Laurino F, et al. Tech- niques and future perspectives for the preven- tion and treatment of endoleaks after endo- vascular repair of abdominal aortic aneurysms. Insights Imaging. 2019;10(1):91. [CrossRef]
  • 10. Conrad MF, Ergul EA, Patel VI, Paruchuri V, Kwolek CJ, Cambria RP. Management of dis- eases of the descending thoracic aorta in the endovascular era: a Medicare population study. Ann Surg. 2010;252(4):603-610. [CrossRef]
  • 11. Fiorucci B, Kölbel T, Rohlffs F, et al. The role of thoracic endovascular repair in elective, symptomatic and ruptured thoracic aortic diseases. Eur J Cardiothorac Surg. 2019;56(1): 197-203. [CrossRef]
  • 12. Ranney DN, Cox ML, Yerokun BA, Benrashid E, McCann RL, Hughes GC. Long-term results of endovascular repair for descending thoracic aortic aneurysms. J Vasc Surg. 2018;67(2):363- 368. [CrossRef]
  • 13. Yamaguchi T, Nakai M, Sumita Y, et al. Editor's choice - endovascular repair versus surgical repair for Japanese patients with ruptured thoracic and abdominal aortic aneurysms: a nationwide study. Eur J Vasc Endovasc Surg. 2019;57(6):779-786. [CrossRef]
  • 14. Ramdass M. TEVAR for symptomatic Stanford B dissection: a systematic review of 30-day mor- tality and morbidity. Thorac Cardiovasc Surg. 2015;63(2):97-112. [CrossRef]
  • 15. Botsios S, Frömke J, Walterbusch G, et al. Secondary interventions after endovascular thoracic aortic repair. J Card Surg. 2014;29(1):66- 73. [CrossRef]
  • 16. Lowry D, Singh J, Mytton J, Tiwari A. Sex- related outcome inequalities in endovascular aneurysm repair. Eur J Vasc Endovasc Surg. 2016;52(4):518-525. [CrossRef]
  • 17. Kasirajan K, Morasch MD, Makaroun MS. Sex- based outcomes after endovascular repair of thoracic aortic aneurysms. J Vasc Surg. 2011; 54(3):669-675. [CrossRef]
  • 18. Cannavale A, Lucatelli P, Corona M, et al. Evolv- ing concepts and management of endoleaks after endovascular aneurysm repair: where do we stand in 2019? Clin Radiol. 2020;75(3): 169-178. [CrossRef]
  • 19. Zaiem F, Almasri J, Tello M, Prokop LJ, Chaikof EL, Murad MH. A systematic review of surveillance after endovascular aortic repair. J Vasc Surg. 2018;67(1):320-331.e37. [CrossRef]
  • 20. Cannavale A, Lucatelli P, Corona M, et al. Current assessment and management of endoleaks after advanced EVAR: new devices, new endoleaks? Expert Rev Cardiovasc Ther. 2020;18(8):465-473. [CrossRef]
  • 21. Parmer SS, Carpenter JP, Stavropoulos SW, et al. Endoleaks after endovascular repair of thoracic aortic aneurysms. J Vasc Surg. 2006; 44(3):447-452. [CrossRef]
  • 22. Cheng D, Martin J, Shennib H, et al. Endovas- cular aortic repair versus open surgical repair for descending thoracic aortic disease a sys- tematic review and meta-analysis of compara- tive studies. J Am Coll Cardiol. 2010;55(10): 986-1001. [CrossRef]
  • 23. Jacobs TS, Won J, Gravereaux EC, et al. Mechani- cal failure of prosthetic human implants: a 10-year experience with aortic stent graft devices. J Vasc Surg. 2003;37(1):16-26. [CrossRef]
  • 24. Fanelli F, Dake MD, Salvatori FM, et al. Manage- ment strategies for thoracic stent-graft repair of distal aortic arch lesions: is intentional sub- clavian artery occlusion a safe procedure? Eur Radiol. 2009;19(10):2407-2415. [CrossRef]
  • 25. Fanelli F, Cannavale A, O'Sullivan GJ, et al. Endovascular repair of acute and chronic aortic Type B dissections: main factors affect- ing aortic remodeling and clinical outcome. JACC Cardiovasc Interv. 2016;9(2):183-191. [CrossRef]
APA Akın M, AKKAN K, Özer A, ILGIT E, Önal A, OKTAR G (2022). Outcomes of endovascular treatment of thoracic aorta pathologies: 10-year single-center results. , 370 - 375. 10.5152/dir.2022.211293
Chicago Akın Mustafa Emre,AKKAN Koray,Özer Abdullah,ILGIT ERHAN TURGUT,Önal Ahmet Baran,OKTAR GURSEL LEVENT Outcomes of endovascular treatment of thoracic aorta pathologies: 10-year single-center results. (2022): 370 - 375. 10.5152/dir.2022.211293
MLA Akın Mustafa Emre,AKKAN Koray,Özer Abdullah,ILGIT ERHAN TURGUT,Önal Ahmet Baran,OKTAR GURSEL LEVENT Outcomes of endovascular treatment of thoracic aorta pathologies: 10-year single-center results. , 2022, ss.370 - 375. 10.5152/dir.2022.211293
AMA Akın M,AKKAN K,Özer A,ILGIT E,Önal A,OKTAR G Outcomes of endovascular treatment of thoracic aorta pathologies: 10-year single-center results. . 2022; 370 - 375. 10.5152/dir.2022.211293
Vancouver Akın M,AKKAN K,Özer A,ILGIT E,Önal A,OKTAR G Outcomes of endovascular treatment of thoracic aorta pathologies: 10-year single-center results. . 2022; 370 - 375. 10.5152/dir.2022.211293
IEEE Akın M,AKKAN K,Özer A,ILGIT E,Önal A,OKTAR G "Outcomes of endovascular treatment of thoracic aorta pathologies: 10-year single-center results." , ss.370 - 375, 2022. 10.5152/dir.2022.211293
ISNAD Akın, Mustafa Emre vd. "Outcomes of endovascular treatment of thoracic aorta pathologies: 10-year single-center results". (2022), 370-375. https://doi.org/10.5152/dir.2022.211293
APA Akın M, AKKAN K, Özer A, ILGIT E, Önal A, OKTAR G (2022). Outcomes of endovascular treatment of thoracic aorta pathologies: 10-year single-center results. Diagnostic and Interventional Radiology, 28(4), 370 - 375. 10.5152/dir.2022.211293
Chicago Akın Mustafa Emre,AKKAN Koray,Özer Abdullah,ILGIT ERHAN TURGUT,Önal Ahmet Baran,OKTAR GURSEL LEVENT Outcomes of endovascular treatment of thoracic aorta pathologies: 10-year single-center results. Diagnostic and Interventional Radiology 28, no.4 (2022): 370 - 375. 10.5152/dir.2022.211293
MLA Akın Mustafa Emre,AKKAN Koray,Özer Abdullah,ILGIT ERHAN TURGUT,Önal Ahmet Baran,OKTAR GURSEL LEVENT Outcomes of endovascular treatment of thoracic aorta pathologies: 10-year single-center results. Diagnostic and Interventional Radiology, vol.28, no.4, 2022, ss.370 - 375. 10.5152/dir.2022.211293
AMA Akın M,AKKAN K,Özer A,ILGIT E,Önal A,OKTAR G Outcomes of endovascular treatment of thoracic aorta pathologies: 10-year single-center results. Diagnostic and Interventional Radiology. 2022; 28(4): 370 - 375. 10.5152/dir.2022.211293
Vancouver Akın M,AKKAN K,Özer A,ILGIT E,Önal A,OKTAR G Outcomes of endovascular treatment of thoracic aorta pathologies: 10-year single-center results. Diagnostic and Interventional Radiology. 2022; 28(4): 370 - 375. 10.5152/dir.2022.211293
IEEE Akın M,AKKAN K,Özer A,ILGIT E,Önal A,OKTAR G "Outcomes of endovascular treatment of thoracic aorta pathologies: 10-year single-center results." Diagnostic and Interventional Radiology, 28, ss.370 - 375, 2022. 10.5152/dir.2022.211293
ISNAD Akın, Mustafa Emre vd. "Outcomes of endovascular treatment of thoracic aorta pathologies: 10-year single-center results". Diagnostic and Interventional Radiology 28/4 (2022), 370-375. https://doi.org/10.5152/dir.2022.211293