Editor's Choice - Hybrid Treatment of Thoracic, Thoracoabdominal, and Abdominal Aortic Aneurysms: A Multicenter Retrospective Study

被引:50
作者
Rosset, E. [1 ]
Ben Ahmed, S. [1 ]
Galvaing, G. [1 ]
Favre, J. P. [2 ]
Sessa, C. [3 ]
Lermusiaux, P. [4 ]
Hassen-Khodja, R. [5 ]
Coggia, M. [6 ]
Haulon, S. [7 ]
Rinckenbach, S. [8 ]
Enon, B. [9 ]
Feugier, P. [3 ]
Steinmetz, E. [10 ]
Becquemin, J. P. [11 ]
机构
[1] CHU Clermont Ferrand, F-63000 Clermont Ferrand, France
[2] CHU St Etienne, St Etienne, France
[3] CHU Grenoble, Grenoble, France
[4] CHU Lyon, Lyon, France
[5] CHU Nice, F-06202 Nice, France
[6] Ambroise Pare Hosp, Paris, France
[7] CHU Lille, Lille, France
[8] CHU Besancon, Besancon, France
[9] CHU Angers, Angers, France
[10] CHU Dijon, Dijon, France
[11] CHU Henri Mondor, F-94010 Creteil, France
关键词
Thoracoabdominal aortic aneurysms; Hybrid procedures; Endovascular aortic repair; SURGICAL REPAIR; MORTALITY; RISK;
D O I
10.1016/j.ejvs.2014.02.013
中图分类号
R61 [外科手术学];
学科分类号
摘要
Objectives: The aim of this study was to assess the results of hybrid techniques for the treatment of thoracic, thoracoabdominal, and abdominal aortic aneurysms based on multicenter results and the various series regarding hybrid procedures reported in the literature. Methods: The results of 76 hybrid procedures performed in 19 French university hospital centers between November 2001 and October 2011 were collected. There were 50 men and 26 women, mean age 68.2 (35-86) years. All patients were considered at high risk (ASA >= 3) for conventional surgery. Aneurysms involved the thoracic, abdominal, and thoracoabdominal aorta in five, 14, and 57 cases respectively. There were 11 emergent repairs. The revascularization of four visceral arteries was performed in 38 cases. Between one and three visceral arteries were revascularized in the other cases. Visceral artery debranching and stent graft deployment were performed in a one-stage procedure in 53 cases and in a two-stage procedure in 23 cases. Results: There were 26 (34.2%) postoperative deaths. Nine of the survivors developed paraplegia, of which one resolved completely. Bowel ischemia occurred in 13 cases (17.1%), and one patient was treated by a superior mesenteric artery. bypass. Four patients required long-term hemodialysis. Postoperative computed tomography scan showed a type II endoleak in two patients. Conclusions: Morbidity and mortality in this study were greater than previously reported. Candidates for hybrid aortic repair should be carefully selected. (C) 2014 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.
引用
收藏
页码:470 / 478
页数:9
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