Search

Your search keyword '"Haulon, Stephan"' showing total 701 results
Start Over Author "Haulon, Stephan"
701 results on '"Haulon, Stephan"'

3. An international, expert-based, Delphi consensus document on controversial issues in the management of abdominal aortic aneurysms

Author

Paraskevas, Kosmas I., Schermerhorn, Marc L., Haulon, Stephan, Beck, Adam W., Verhagen, Hence J.M., Lee, Jason T., Verhoeven, Eric L.G., Blankensteijn, Jan D., Kölbel, Tilo, Lyden, Sean P., Clair, Daniel G., Faggioli, Gianluca, Bisdas, Theodosios, D'Oria, Mario, Mani, Kevin, Sörelius, Karl, Gallitto, Enrico, Fernandes e Fernandes, Jose, Katsargyris, Athanasios, Lepidi, Sandro, Vacirca, Andrea, Myrcha, Piotr, Koelemay, Mark J.W., Mansilha, Armando, Zeebregts, Clark J., Pini, Rodolfo, Dias, Nuno V., Karelis, Angelos, Bosiers, Michel J., Stone, David H., Venermo, Maarit, Farber, Mark A., Blecha, Matthew, Melissano, Germano, Riambau, Vincent, Eagleton, Matthew J., Gargiulo, Mauro, Scali, Salvatore T., Torsello, Giovanni B., Eskandari, Mark K., Perler, Bruce A., Gloviczki, Peter, Malas, Mahmoud, and Dalman, Ronald L.

Published
2025
Full Text
View/download PDF

5. Urgent Candy-Plug technique for distal false lumen occlusion in chronic aortic dissection

Author

Mougin, Justine, Nyman, Johan, Sonesson, Björn, Fernandez, Carlota, Lindsay, Thomas, Reeps, Christian, Lutz, Brigitta, Trimarchi, Santi, Lomazzi, Chiara, Sobocinski, Jonothan, Kerezsy, Michael, van Rijswijk, Catharina S.P., van Schaik, J., Pfister, Karin, Mialhe, Claude, Tielliu, Ignace, Modarai, Bijan, Florek, Hans-Joachim, Jakimowicz, Tomasz, Cheng, Stephen, Chiesa, Roberto, Salvati, Simone, Eleshra, Ahmed, Kölbel, Tilo, Haulon, Stephan, Bertoglio, Luca, Rohlffs, Fiona, Dias, Nuno, Panuccio, Giuseppe, and Tsilimparis, Nikolaos

Published
2024
Full Text
View/download PDF

6. Urgent endovascular repair of juxtarenal/pararenal aneurysm by off-the-shelf multibranched endograft

Author

Antonello, M., Arzola, H., Austerman, M., Berekoven, B., Bertoglio, L., Bonardelli, S., Bonvini, S., Cappiello, A., Cecere, F., Chiesa, R., Dias, N., Di Marzo, L., D'Oria, M., Faggioli, G., Ferrer, C., Fontaine, V., Freyrie, A., Gallitto, E., Gargiulo, M., Giudice, R., Haulon, S., Isernia, G., Leone, N., Lepidi, S., Mani, K., Mansour, W., Melissano, G., Melloni, A., Melo, R., Mendes Pedro, L., Mezzetto, L., Mitta, N., Nana, P., Oikonou, K., Panuccio, G., Perini, P., Pini, R., Pratesi, G., Pulli, R., Piazza, M., Kahlberg, A., Karelis, A., Katsargyris, A., Kolbel, T., Silingardi, R., Simonte, G., Spath, P., Squizzato, F., Tinelli, G., Torrealba, J., Tsilimparis, N., Wanhainen, A., Vacirca, A., Veraldi, G., Gallitto, Enrico, Faggioli, Gianluca, Austermann, Martin, Kölbel, Tilo, Tsilimparis, Nikolas, Dias, Nuno, Melissano, Germano, Simonte, Gioele, Katsargyris, Athanasios, Oikonomou, Kyriakos, Mani, Kevin, Pedro, Luis Mendes, Cecere, Fabrizio, Haulon, Stephan, and Gargiulo, Mauro

Published
2024
Full Text
View/download PDF

7. Editor's Choice -- European Society for Vascular Surgery (ESVS) 2024 Clinical Practice Guidelines on the Management of Abdominal Aorto-Iliac Artery Aneurysms

Author

Wanhainen, Anders, Van Herzeele, Isabelle, Bastos Goncalves, Frederico, Bellmunt Montoya, Sergi, Berard, Xavier, Boyle, Jonathan R., D’Oria, Mario, Prendes, Carlota F., Karkos, Christos D., Kazimierczak, Arkadiusz, Koelemay, Mark J.W., Kölbel, Tilo, Mani, Kevin, Melissano, Germano, Powell, Janet T., Trimarchi, Santi, Tsilimparis, Nikolaos, Antoniou, George A., Björck, Martin, Coscas, Raphael, Dias, Nuno V., Kolh, Philippe, Lepidi, Sandro, Mees, Barend M.E., Resch, Timothy A., Ricco, Jean Baptiste, Tulamo, Riikka, Twine, Christopher P., Branzan, Daniela, Cheng, Stephen W.K., Dalman, Ronald L., Dick, Florian, Golledge, Jonathan, Haulon, Stephan, van Herwaarden, Joost A., Ilic, Nikola S., Jawien, Arkadiusz, Mastracci, Tara M., Oderich, Gustavo S., Verzini, Fabio, and Yeung, Kak Khee

Published
2024
Full Text
View/download PDF

12. Role of Antiplatelet Therapy in Patients Managed for Complex Aortic Aneurysms using Fenestrated or Branched Endovascular Repair

Author

Debus, Eike Sebastian, Blessing, Erwin, Panuccio, Giuseppe, Rohlffs, Fiona, Torrealba, José I., Ali, Ahmed, Stana, Jan, Le Houérou, Thomas, Mesnard, Thomas, Cappiello, Antonio, Karelis, Angelos, Berczeli, Márton, Sotir, Anna, Arzola, Luis Hector, Bresler, Alina-Marilena, Melloni, Andrea, Bonardelli, Stefano, van Schaik, Jan, Rasiah, Michael Greshan, Conradsen, Rebecca Andrea, Dakis, Konstantinos, Kouvelos, George, Matsagkas, Miltiadis, Nana, Petroula, Spanos, Konstantinos, Tsilimparis, Nikolaos, Haulon, Stéphan, Sobocinski, Jonathan, Gallitto, Enrico, Dias, Nuno, Eilenberg, Wolf, Wanhainen, Anders, Mani, Kevin, Böckler, Dittmar, Bertoglio, Luca, van Rijswijk, Carla, Modarai, Bijan, Seternes, Arne, Enzmann, Florian K., Giannoukas, Athanasios, Gargiulo, Mauro, and Kölbel, Tilo

Published
2024
Full Text
View/download PDF

15. Custom Made Candy Plug for Distal False Lumen Occlusion in Aortic Dissection: International Experience

Author

Mougin, Justine, Chiesa, Roberto, Salvati, Simone, Nyman, Johan, Sonesson, Björn, Reeps, Christian, Lutz, Brigitta, Trimarchi, Santi, Lomazzi, Chiara, Sobocinski, Jonothan, Kerezsy, Michael, van Rijswijk, Catharina S.P., van Schaik, J., Pfister, Karin, Mialhe, Claude, Tielliu, Ignace, Modarai, Bijan, Florek, Hans-Joachim, Jakimowicz, Tomasz, Cheng, Stephen, Eleshra, Ahmed, Haulon, Stephan, Bertoglio, Luca, Lindsay, Thomas, Rohlffs, Fiona, Dias, Nuno, Tsilimparis, Nikolaos, Panuccio, Giuseppe, and Kölbel, Tilo

Published
2023
Full Text
View/download PDF

18. Editor's Choice – European Society for Vascular Surgery (ESVS) 2023 Clinical Practice Guidelines on Radiation Safety

Author

Modarai, Bijan, Haulon, Stéphan, Ainsbury, Elizabeth, Böckler, Dittmar, Vano-Carruana, Eliseo, Dawson, Joseph, Farber, Mark, Van Herzeele, Isabelle, Hertault, Adrien, van Herwaarden, Joost, Patel, Ashish, Wanhainen, Anders, Weiss, Salome, ESVS Guidelines Committee, Bastos Gonçalves, Frederico, Björck, Martin, Chakfé, Nabil, de Borst, Gert J., Coscas, Raphaël, Dias, Nuno V., Dick, Florian, Hinchliffe, Robert J., Kakkos, Stavros K., Koncar, Igor B., Kolh, Philippe, Lindholt, Jes S., Trimarchi, Santi, Tulamo, Riikka, Twine, Christopher P., Vermassen, Frank, Document Reviewers, Bacher, Klaus, Brountzos, Elias, Fanelli, Fabrizio, Fidalgo Domingos, Liliana A., Gargiulo, Mauro, Mani, Kevin, Mastracci, Tara M., Maurel, Blandine, Morgan, Robert A., and Schneider, Peter

Published
2023
Full Text
View/download PDF

21. Editor's Choice – PRINciples of optimal antithrombotiC therapy and coagulation managEment during elective fenestrated and branched EndovaScular aortic repairS (PRINCE2SS): An International Expert Based Delphi Consensus Study

Author

Abisi, Said, Adam, Donald, Antonello, Michele, Austermann, Martin, Beck, Adam W., Berard, Xavier, Bisdas, Theodosios, Böckler, Dittmar, Budtz-Lilly, Jacob, Cheng, Stephen W.K., Czerny, Martin, DeMartino, Randall, Dias, Nuno, Donas, Konstantinos P., Eagleton, Matthew J., Farber, Mark A., Fargion, Aaron Thomas, Ferreira, Marcelo, Forbes, Thomas L., Gargiulo, Mauro, Gasper, Warren J., Jakimowicz, Tomasz, Haulon, Stéphan, Hockley, Joseph A., Holden, Andrew, Holt, Peter, Kahlberg, Andrea, Khashram, Manar, Kotelis, Drosos, Lundberg, Göran, Maldonado, Thomas S., Mangialardi, Nicola, Mastracci, Tara M., Maurel, Blandine, Milner, Ross, Modarai, Bijan, Pannuccio, Giuseppe, Parlani, Gianbattista, Pratesi, Giovanni, Pulli, Raffaele, Qasabian, Raffi A., Reijnen, Michel M.P. J., Resh, Timothy, Riambau, Vincente, Settembre, Nicla, Schanzer, Andres, Schmidt, Andrej, Schneider, Darren, Schurink, Geert Willem H., Silingardi, Roberto, Sobocinski, Jonathan, Soler, Raphael, Sweet, Matthew P., Leong Tan, Glenn Wei, Tenorio, Emanuel R., Tielliu, Ignace F.J., Timaran, Carlos H., Tshomba, Yamume, Tsilimparis, Nikolaos, Van den Eynde, Wouter, Vasudevan, Thodur, Veraldi, Gian Franco, Verhagen, Hence JM., Verhoeven, Eric, Verzini, Fabio, Wanhainen, Anders, Zimmermann, Alexander, D’Oria, Mario, Bertoglio, Luca, Bignamini, Angelo Antonio, Mani, Kevin, Kölbel, Tilo, Oderich, Gustavo, Chiesa, Roberto, and Lepidi, Sandro

Published
2022
Full Text
View/download PDF

22. Balloon-Expandable Cheatham-Platinum Stents Versus Self-Expandable Nitinol Stents in Coarctation of Aorta: A Randomized Controlled Trial

Author

Sadeghipour, Parham, Mohebbi, Bahram, Firouzi, Ata, Khajali, Zahra, Saedi, Sedigheh, Shafe, Omid, Pouraliakbar, Hamid Reza, Alemzadeh-Ansari, Mohammad Javad, Shahdi, Shabnam, Samiei, Niloufar, Sadeghpour, Anita, Babaei, Mohammadreza, Ghadrdoost, Behshid, Afrooghe, Arya, Rokni, Mehrad, Dabbagh Ohadi, Mohammad Amin, Hosseini, Zahra, Abdi, Seifollah, Maleki, Majid, Bassiri, Hossein-Ali, Haulon, Stephan, and Moosavi, Jamal

Published
2022
Full Text
View/download PDF

25. Editor's Choice – Multicentre Outcomes of Redo Fenestrated/Branched Endovascular Aneurysm Repair to Rescue Failed Fenestrated Endografts

Author

Marqués, Pablo, Tenorio, Emanuel Ramos, Claridge, Martin, Casali, Francesco, Tsilimparis, Nikolaos, Sobocinski, Jonathan, Katsargyris, Athanasios, Karelis, Angelos, Haulon, Stéphan, Sonesson, Björn, Adam, Donald, Kölbel, Tilo, Oderich, Gustavo, Cieri, Enrico, Mesnard, Thomas, Verhoeven, Eric, and Dias, Nuno

Published
2021
Full Text
View/download PDF

26. Mid-Term Survival and Risk Factors Associated With Myocardial Injury After Fenestrated and/or Branched Endovascular Aortic Aneurysm Repair

Author

Moussa, Mouhamed D., Lamer, Antoine, Labreuche, Julien, Brandt, Caroline, Mass, Guillaume, Louvel, Paul, Lecailtel, Sylvain, Mesnard, Thomas, Deblauwe, Delphine, Gantois, Guillaume, Nodea, Madalina, Desbordes, Jacques, Hertault, Adrien, Saddouk, Noredine, Muller, Christophe, Haulon, Stéphan, Sobocinski, Jonathan, and Robin, Emmanuel

Published
2021
Full Text
View/download PDF

35. Urgent Candy-Plug technique for distal false lumen occlusion in chronic aortic dissection.

Author

Eleshra, Ahmed, Kölbel, Tilo, Haulon, Stephan, Bertoglio, Luca, Rohlffs, Fiona, Dias, Nuno, Panuccio, Giuseppe, and Tsilimparis, Nikolaos

Abstract

This study aimed to assess the impact of urgency on early and midterm outcomes of the Candy-Plug (CP) technique for distal false lumen (FL) occlusion in thoracic endovascular aortic repair for aortic dissection. The CP registry was reviewed, and patients were categorized into elective and urgent/emergent groups for analysis. End points included technical success, clinical success, early (30-day) computed tomography angiography findings, early (30-day) mortality, adverse events, and aortic remodeling in patients with available computed tomography angiography follow-up and reintervention. A total of 155 patients received a custom-made CP, of whom 32 patients (44% male, mean age 61 ± 9 years) were treated urgently and 123 patients (63% male, mean age 62 ± 11 years) electively. The primary CP rate was higher in the urgent group (28/32, 88%, in the urgent group vs 96/123, 78%, in the elective group, P =.051). The mean contrast volume was higher in the urgent group (157 ± 56 mL in the urgent group vs 130 ± 71 mL in the elective group, P =.017). Technical success was achieved in all patients in both groups. Clinical success was achieved in 25 of 32 (78%) patients in the urgent group vs 113 and 123 (92%) in the elective group (P =.159). The early mortality rate was 13% (4 of 32 patients) in the urgent group vs 1% (1 of 123 patients) in the elective group (P =.120). There was no statistically significant difference regarding the early adverse events between the urgent and elective CP groups. Early aortic-related reinterventions were required in 6 of 32 (19%) patients in the urgent group vs 6 of 123 (5%) in the elective group (P =.094). Thoracic aortic aneurysm sac regression was lower in the urgent group (5/28, 18%, in the urgent group vs 63/114, 55%, in the elective group, P =.001). Stable thoracic aortic aneurysm sac was higher in the urgent group (22/28, 79%, in the urgent group vs 47/114, 41%, in the elective group, P =.000). An increase in thoracic aortic aneurysm sac occurred in 1 of 28 (4%) patients in the urgent group vs 4 of 114 (4%) patients in the elective group (P =.096). The urgent use of the CP technique for distal FL occlusion in aortic dissection was feasible and effective. The decrease in aortic FL sac diameter may be affected by the urgent use of CP due to limited sizing availability. However, it achieved a high rate of aortic remodeling. [ABSTRACT FROM AUTHOR]

Published
2024
Full Text
View/download PDF

36. Urgent endovascular repair of juxtarenal/pararenal aneurysm by off-the-shelf multibranched endograft.

Author

Gallitto, Enrico, Faggioli, Gianluca, Austermann, Martin, Kölbel, Tilo, Tsilimparis, Nikolas, Dias, Nuno, Melissano, Germano, Simonte, Gioele, Katsargyris, Athanasios, Oikonomou, Kyriakos, Mani, Kevin, Pedro, Luis Mendes, Cecere, Fabrizio, Haulon, Stephan, and Gargiulo, Mauro

Abstract

To report outcomes of urgent juxtarenal/pararenal aneurysms (J/P-AAAs) managed by off-the-shelf multibranched thoracoabdominal endografts (Cook, T-branch). In this observational, multicenter, retrospective study, patients with J/P-AAAs treated by urgent endovascular repair by T-branch in 23 European aortic centers, from 2013 to 2023, were analyzed. Contained J/P-AAAs rupture, presence of related symptoms, and aneurysm diameter of >70 mm were considered as indication for urgent repair. Technical success (TS), spinal cord ischemia (SCI), and 30-day/hospital mortality were assessed as early outcomes. Survival, freedom from reinterventions, and target artery instability (TAI) were evaluated during follow-up. Overall, 197 patients (J-AAAs, n = 64 [33%]; P-AAAs, n = 95 [48%]; previous failed endovascular aneurysm repair (EVAR), n = 38 [19%]) were analyzed. The mean age and aneurysm diameter was 75 ± 8 years and 76 ± 4 mm, respectively. The American Society of Anesthesiologists score was 3 and 4 in 118 (60%) and 79 (40%) patients. Rupture, symptoms, and diameter of >70 mm were present in 51 (26%), 110 (56%), and 53 (27%) patients, respectively. An adjunctive proximal thoracic endograft was used in 28 cases (14%). The mean aortic coverage between the upper portion of the endograft and the lowest renal artery was 154 ± 49 mm. Single-stage repair and cerebrospinal fluid drainage were reported in 144 (73%) and 53 (27%) cases, respectively. TS was achieved in 182 (92%) cases (rupture, 84% vs no rupture, 95%; P =.02). Failures consist of TA loss (11 [6%]: renal artery, 9; celiac trunk, 2), type I to III endoleaks (2 [1%]), and 24-h mortality (2 [1%]). Rupture was a risk factor for technical failure (P =.02; odds ratio [OR], 3.8; 95% confidence interval [CI], 1.1-12.1). Overall, 15 patients (8%) had persistent SCI (rupture, 14% vs no rupture, 5%) with 11 (6%) , of paraplegia (rupture, 10% vs no rupture, 5%; P =.001). Rupture (P =.04; OR, 3.1; 95% CI, 1.1-8.9) and adjunctive proximal thoracic endograft (P =.01; OR, 4.1; 95% CI, 1.3-12.9) were risk-factors for SCI. Twenty-two patients (11%) died within 30 days or during a prolonged hospitalization. Previous failed EVAR (P =.04; OR, 3.6; 95% CI, 1.1-12.3), paraplegia (P <.001; OR, 9.9; 95% CI, 1.6-62.2) and postoperative mesenteric complications (P =.03; OR, 10.4; 95% CI, 1.2-93.3), as well as cardiac (P =.03; OR, 8.2; 95% CI, 2.0-33.0) and respiratory (P <.001; OR, 10.1; 95% CI, 2.9-35.2) morbidities were associated with 30-day/hospital mortality. The mean follow-up was 19 ± 5 months. The estimated 3-year survival and freedom from reinterventions was 58% and 77%, respectively. TAI occurred in 27 patients (14%) (occlusion, 15; endoleak, 14) with an estimated 3-year freedom from TAI of 72%. Urgent repair of J/P-AAAs by T-branch is feasible and effective with satisfactory TS and 30-day/hospital mortality in high-risk patients. However, extensive aortic coverage is necessary, leading to a non-negligible SCI rate, especially in case of aortic rupture or when adjunctive thoracic endografts are necessary. Previous failed EVAR and postoperative mesenteric complications, as well as cardiac and respiratory morbidities were associated with 30-day/hospital mortality and should be subjected to more research for the purposes of improving outcomes. [ABSTRACT FROM AUTHOR]

Published
2024
Full Text
View/download PDF

43. The sac evolution imaging follow-up after endovascular aortic repair : An international expert opinion-based Delphi consensus study

Author

Tinelli, Giovanni, D'Oria, Mario, Sica, Simona, Mani, Kevin, Rancic, Zoran, Resch, Timothy Andrew, Beccia, Flavia, Azizzadeh, Ali, Martins Da Volta Ferreira, Marcelo, Gargiulo, Mauro, Lepidi, Sandro, Tshomba, Yamume, Oderich, Gustavo S., Haulon, Stephan, Tinelli, Giovanni, D'Oria, Mario, Sica, Simona, Mani, Kevin, Rancic, Zoran, Resch, Timothy Andrew, Beccia, Flavia, Azizzadeh, Ali, Martins Da Volta Ferreira, Marcelo, Gargiulo, Mauro, Lepidi, Sandro, Tshomba, Yamume, Oderich, Gustavo S., and Haulon, Stephan

Abstract

Objective Management of follow-up protocols after endovascular aortic repair (EVAR) varies significantly between centers and is not standardized according to sac regression. By designing an international expert-based Delphi consensus, the study aimed to create recommendations on follow-up after EVAR according to sac evolution. Methods Eight facilitators created appropriate statements regarding the study topic that were voted, using a 4-point Likert scale, by a selected panel of international experts using a three-round modified Delphi consensus process. Based on the experts' responses, only those statements reaching a grade A (full agreement ≥75%) or B (overall agreement ≥80% and full disagreement <5%) were included in the final document. Results One-hundred and seventy-four participants were included in the final analysis, and each voted the initial 29 statements related to the definition of sac regression (Q1-Q9), EVAR follow-up (Q10-Q14), and the assessment and role of sac regression during follow-up (Q15-Q29). At the end of the process, 2 statements (6.9%) were rejected, 9 statements (31%) received a grade B consensus strength, and 18 (62.1%) reached a grade A consensus strength. Of 27 final statements, 15 (55.6%) were classified as grade I, whereas 12 (44.4%) were classified as grade II. Experts agreed that sac regression should be considered an important indicator of EVAR success and always be assessed during follow-up after EVAR. Conclusions Based on the elevated strength and high consistency of this international expert-based Delphi consensus, most of the statements might guide the current clinical management of follow-up after EVAR according to the sac regression. Future studies are needed to clarify debated issues.

Published
2024
Full Text
View/download PDF

45. Doppler echocardiography for surveillance of acute cardiac allograft rejection: a 28-year single-center experience

Author

Vallée, Aurélien, primary, Houyel, Lucile, additional, To, Ngoc Tram, additional, Fels, Audrey, additional, Kloeckner, Martin, additional, Blanchard, David, additional, Lemann, Thomas, additional, Gaillard, Maïra, additional, Ramadan, Ramzi, additional, Genty, Thibaut, additional, Montpreville, Vincent Thomas de, additional, Beaussier, Hélène, additional, Chatellier, Gilles, additional, Deleuze, Philippe, additional, Haulon, Stephan, additional, and Guihaire, Julien, additional

Published
2024
Full Text
View/download PDF

46. European Society for Vascular Surgery (ESVS) 2024 Clinical Practice Guidelines on the Management of Abdominal Aorto-Iliac Artery Aneurysms

Author

Wanhainen, Anders, primary, Van Herzeele, Isabelle, additional, Bastos Goncalves, Frederico, additional, Bellmunt Montoya, Sergi, additional, Berard, Xavier, additional, Boyle, Jonathan R., additional, D’Oria, Mario, additional, Prendes, Carlota F., additional, Karkos, Christos D., additional, Kazimierczak, Arkadiusz, additional, Koelemay, Mark J.W., additional, Kölbel, Tilo, additional, Mani, Kevin, additional, Melissano, Germano, additional, Powell, Janet T., additional, Trimarchi, Santi, additional, Tsilimparis, Nikolaos, additional, Antoniou, George, additional, Björck, Martin, additional, Coscas, Raphael, additional, Dias, Nuno V., additional, Kolh, Philippe, additional, Lepidi, Sandro, additional, Mees, Barend M.E., additional, Resch, Timothy A., additional, Ricco, Jean Baptiste, additional, Tulamo, Riikka, additional, Twine, Chris P., additional, Branzan, Daniela, additional, Cheng, Stephen W.K., additional, Dalman, Ronald L., additional, Dick, Florian, additional, Golledge, Jonathan, additional, Haulon, Stephan, additional, van Herwaarden, Joost A., additional, Ilic, Nikola S., additional, Jawien, Arkadiusz, additional, Mastracci, Tara M., additional, Oderich, Gustavo S., additional, Verzini, Fabio, additional, and Yeung, Kak K., additional

Published
2024
Full Text
View/download PDF

47. Systematic Review on Customized and Non-customized Device Techniques for the Endovascular Repair of the Aortic Arch.

Author

Nana, Petroula, Spanos, Konstantinos, Dakis, Konstantinos, Giannoukas, Athanasios, Kölbel, Tilo, and Haulon, Stephan

Abstract

Purpose: Open repair remains the standard of care for aortic arch pathologies. However, endovascular management became an attractive alternative for high-risk patients. This study aimed to assess the outcomes of the available endovascular techniques for aortic arch pathology management. Materials and Methods: A search of the English literature (2000–2022) using PubMed, EMBASE, via Ovid, and CENTRAL databases (February 1, 2022) was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Studies reporting on patients with aortic arch pathologies managed with custom-made devices ([CMDs] fenestrated or branched thoracic endovascular aortic repair [F/BTEVAR]) and non-CMDs (parallel graft or surgeon-modified FTEVAR) were eligible. Studies reporting on hybrid or open repair were excluded. Studies' quality was assessed using the Newcastle-Ottawa Scale. Primary outcomes were technical success, 30 day mortality, and cerebrovascular events (CVEs). Secondary outcomes were re-intervention and mortality during follow-up. Results: Thirty studies (2135 patients) were included. Treatment indications were mainly dissections (652 cases [48.0%, 652/1358]; 90 type A, 506 type B; 364 acute, 163 chronic) and aneurysms (46.9%, 582/1239). Five studies (211 patients) reported on FTEVAR and 10 (388 patients) on BTEVAR. For FTEVAR, technical success rate was 98.3%. Thirty-day mortality was 3.8% and CVE rate was 12.3%. Ten deaths (9.7%) and 19 re-interventions (9%) were recorded during follow-up (24 months). Regarding BTEVAR, technical success rate was 98.7%, and 30 day mortality and CVE rates were 5.4% and 11.0%, respectively. During follow-up (27 months), 64 deaths (18.7%) and 33 re-interventions (9.6%) were recorded. Parallel graft technique was reported in 11 studies (901 patients). Technical success rate was 76.4%. Thirty-day mortality was 3.9% and 32 (4.3%) CVEs were recorded. Thirty-five deaths (4.4%) and 43 re-interventions (5.5%) were reported during follow-up (27 months). Surgeon-modified FTEVAR was described in 5 studies (635 patients). Technical success rate was 91.6%. At 30 days, 15 deaths (2.3%) and 22 CVEs (3.5%) were recorded. During follow-up (19 months), 26 deaths (4.2%) and 21 re-interventions (3.6%) were detected. Conclusions: Endovascular arch repair presented a variable technical success; >95% for F/BTEVAR; ≤90% for non-CMDs. Acceptable 30 day mortality rates were reported. Cerebrovascular event rates ranged up to 10%. These findings, adjacent to the estimated midterm mortality and re-interventions, set the need for further improvement. Clinical Impact: Endovascular arch repair gains popularity as a valuable alternative, especially in patients considered unfit for open repair. According the available literature, any endovascular technique, including custom-made or off-the-shelf solutions, may be applied successfully, with acceptable early mortality. However, the perio-operative cerebrovascular event rate is still an issue, indicating the need for further advancements. [ABSTRACT FROM AUTHOR]

Published
2024
Full Text
View/download PDF

Catalog

Books, media, physical & digital resources
See catalog results