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ȣ - 550026 326 |
Hybrid endovascular repair for aortic arch pathology: Intermediate outcomes and complications |
가천의대 길병원 심장내과¹, 흉부외과², 혈관외과³, 연세대학교 세브란스병원 심장내과⁴, 흉부외과 5 |
강웅철¹ , 신익균¹ , 박철현² , 강진모³ , 고영국⁴ , 최동훈⁴ , 심원흠⁴ , 윤영남5 |
Purpose To evaluate the outcomes of hybrid endovascular repair for aortic arch pathology.
Methods This study was a retrospective analysis involving patients who underwent hybrid endovascular repair for aortic arch pathologies.
Results Twenty-one patients (16 men; mean age, 64.7±16.2 years) with aortic arch pathologies were treated by hybrid endovascular repair. The indications for surgery included increased aneurysm size in 11 cases (52.4%), rupture or impending aneurysmal rupture in 5 cases (23.8%), and progressive aortic dissection in 5 cases (23.8%). Supra-aortic vessel transposition and stent-graft implantation were achieved in all cases. Two types of stent-graft was used, as follows: the Seal thoracic stent-graft in 14 patients (66.7%); and the Valiant stent grafts in 7 patients (33.3%). Peri-operative complications affected 5 patients (23.8%), as follows: bleeding (n=4, 19.0%); stroke (n=3, 14.3%); renal failure (n=2, 9.5%); vascular injury (n=1, 4.8%), and respiratory failure (n=1, 4.8%). Two patients died within 30 days (9.5%). Technical success was achieved in 15 patients (71.5%). Early endoleaks were noted in 4 patients (19.0%). One patient died during follow-up (mean, 21.3±11.6 months) due to a de novo aortic dissection. Persistent early endoleaks were noted in 4 patients (19.0%); 2 of the 4 patients were successfully managed with implantation of additional stent-grafts. No late onset endoleaks were noted. The death-free survival and re-intervention-free survival rates during follow-up were 85.7% and 89.5%, respectively.
Conclusion Hybrid endovascular repair provides a feasible alternative treatment and may serve an important role in treating patients with aortic arch pathology less invasively.
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