Hybrid open-endovascular repair for thoracoabdominal aortic aneurysms: Current status and level of evidence

被引:66
作者
Donas, K. P.
Czerny, M.
Guber, I.
Teufelsbauer, H.
Nanobachvili, J.
机构
[1] Med Univ Vienna, Dept Cardiothorac Surg, A-1090 Vienna, Austria
[2] Med Univ Vienna, Dept Vasc Surg, A-1090 Vienna, Austria
关键词
hybrid; open-endovascular repair; thoraco-abdominal aortic aneurysm; systematic review;
D O I
10.1016/j.ejvs.2007.05.023
中图分类号
R61 [外科手术学];
学科分类号
摘要
Purpose. To report the results of a systematic review of the literature and to provide evidence for the hybrid open-endovascular repair (HOER) in patients with thoracoabdominal aortic aneurysms (TAAAs). Methods. A comprehensive literature review was performed and all studies identified that reported the results of HOER in patients with TAAA and information about primary technical and clinical success in evaluating the immediate and longterm complications such as neurological, renal and respiratory morbidity. All studies were reviewed by two independent observers-for the above mentioned parameters. Results. After careful selection according to the given criteria, 13 studies were included in our statistical analysis. The number of reported patients totalled 58. Of those, 37 were men (64.4%) and the mean age of the patients was 68.1 years (range 35-80, 95%CI [72.8, 64.9]). All patients were unfit for open repair with severe comorbidities. The mean follow-up period was 14.5 +/- 8.7 months (range 4-36, 95%CI [18.7, 9.9]) and the mean aneurysm diameter was 7.15 cm (range 5 to 12, 95%CI [7.87, 6.69]). 229 (97.8%) of the 234 visceral vessel grafts remained patent during the follow-up period. Reintervention was necessary in one (1.6%) of the five patients with an occluded graft. The overall long-term endoleak rate was 20.6% (12158 patients) and the reintervention rate was 13.7% (8158 patients). No patients developed procedure-related neurological deficits. The overall early and long-term mortality rate for completed procedures was 15.5% (9158). Conclusions. HOER shows promising mid-term results for high-risk patients who have TAAA, however, present evidence does not allow robust conclusions. (C) 2007 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.
引用
收藏
页码:528 / 533
页数:6
相关论文
共 26 条
[1]   Repair of coexistent infrarenal and thoracoabdominal aortic aneurysm: Combined endovascular and open surgical procedure with visceral vessel relocation [J].
Agostinelli, A ;
Saccani, S ;
Budillon, AM ;
Nicolini, F ;
Beghi, C ;
Larini, P ;
Gherli, T .
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 2002, 124 (01) :184-185
[2]   Complex thoracoabdominal aortic aneurysms: Endovascular exclusion with visceral revascularization [J].
Black, Stephen Alan ;
Wolfe, John H. N. ;
Clark, Martin ;
Hamady, Mohammed ;
Cheshire, Nicholas J. W. ;
Jenkins, Michael P. .
JOURNAL OF VASCULAR SURGERY, 2006, 43 (06) :1081-1088
[3]   Two-stage combined endovascular and surgical approach for recurrent thoracoabdominal aortic aneurysm [J].
Chiesa, R ;
Melissano, G ;
Civilini, E ;
Setacci, F ;
Tshomba, Y ;
Anzuini, A .
JOURNAL OF ENDOVASCULAR THERAPY, 2004, 11 (03) :330-333
[4]  
Chuter TAM, 2001, J ENDOVASC THER, V8, P25, DOI 10.1583/1545-1550(2001)008<0025:AESFTA>2.0.CO
[5]  
2
[6]   Multi-branched stent-craft for type III thoracoabdominal aortic aneurysm [J].
Chuter, TAM ;
Gordon, RL ;
Reilly, LM ;
Pak, LK ;
Messina, LM .
JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY, 2001, 12 (03) :391-392
[7]   Thoracoabdominal aortic aneurysm repair: Review and update of current strategies [J].
Coselli, JS ;
Conklin, LD ;
LeMaire, SA .
ANNALS OF THORACIC SURGERY, 2002, 74 (05) :S1881-S1884
[8]  
Donas KP, 2007, INT ANGIOL, V26, P213
[9]   Neurologic outcome after thoracic and thoracoabdominal aortic aneurysm repair [J].
Estrera, AL ;
Miller, CC ;
Huynh, TTT ;
Porat, E ;
Safi, HJ .
ANNALS OF THORACIC SURGERY, 2001, 72 (04) :1225-1230
[10]   Retrograde visceral vessel revascularization followed by endovascular aneurysm exclusion as an alternative to open surgical repair of thoracoabdominal aortic aneurysm [J].
Flye, MW ;
Choi, ET ;
Sanchez, LA ;
Curci, JA ;
Thompson, RW ;
Rubin, BG ;
Geraghty, PJ ;
Sicard, GA .
JOURNAL OF VASCULAR SURGERY, 2004, 39 (02) :454-458