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iTalian RegIstry of doUble inner branch stent graft for arch PatHology (the TRIUmPH Registry)
- Publication Year :
- 2019
-
Abstract
- Objective The objective of this study was to assess early and midterm results after endovascular aortic arch repair using a double inner branch stent graft (DIBSG) in patients with aortic arch aneurysm or dissection unfit for open surgery. Methods Between 2012 and 2018, there were 24 patients with aortic arch disease who were treated with a single model of a DIBSG (Terumo Aortic, Glasgow, United Kingdom) in nine Italian cardiovascular centers. We investigated technical success, mortality, occurrence of major complications, and need for reintervention in a multicenter, nonrandomized, retrospective fashion. Results The in-hospital mortality rate was 16.7%. Cerebrovascular events occurred in 25% of patients and major strokes in 12.5%. Two patients experienced a retrograde dissection (8.3%), whereas none reported any type I or type III endoleak. During a mean follow-up of 18 months (range, 1-60 months), one patient died of a nonaortic cause and one reported a nonarch-related major stroke. No late secondary intervention was needed during the follow-up. Excluding from the analysis the first six patients treated until 2014 as part of the learning curve, in-hospital mortality, major stroke, and retrograde dissection rates were 11.1%, 11.1%, and 5.6%, respectively. Conclusions Endovascular aortic arch repair using this model of DIBSG is feasible, and results are acceptable for a new technique in a high-risk subset of patients. Operative mortality suffers the effect of a learning curve, whereas midterm aorta-related survival is promising. Endovascular repair of aortic arch disease with a DIBSG should always be considered to give high-risk patients a chance of repair. Large-scale studies are needed to assess the long-term durability of this technique.
- Subjects :
- Aortic arch
Male
Time Factors
medicine.medical_treatment
Aorta, Thoracic
030204 cardiovascular system & hematology
0302 clinical medicine
Postoperative Complications
Risk Factors
030212 general & internal medicine
Major complication
Hospital Mortality
Registries
Arch
Stroke
Aged, 80 and over
Mortality rate
Endovascular Procedures
Aortic arch aneurysm
Endovascular aortic arch repair
Middle Aged
Settore MED/22 - CHIRURGIA VASCOLARE
Dissection
Treatment Outcome
Italy
Female
Stents
Clinical Competence
Cardiology and Cardiovascular Medicine
Learning Curve
medicine.medical_specialty
Aortic Diseases
Thoracic endovascular aortic repair
Prosthesis Design
03 medical and health sciences
Blood Vessel Prosthesis Implantation
Inner branch stent graft
Thoracic stent graft
medicine.artery
medicine
Humans
Aged
Retrospective Studies
business.industry
Surgery
Stent
medicine.disease
Blood Vessel Prosthesis
business
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....7113777cecab9ef63051bc2f432b9873