background: durability of low-profile branched aortic stent-grafts (LPSG) in the treatment of patients with thoracoabdominal aortic aneurysms (TAAA) remains unclear. objective of this study is to compare the outcomes of LPSG with standard profile branched aortic stent-grafts (SPSG). methods: between January 2016 and january 2020, 225 consecutive patients with TAAA were treated by branched endovascular aortic repair (BEVAR). twenty-four patients who were treated with a LPSG were compared to 24 patients who received SPSG as a control group. control patients were selected according to aneurysm size (maximum aneurysm diameter) and extension (Crawford classification) as well as availability of adequate preoperative and postoperative CT-angiograms at 24 months. the primary endpoint was ongoing clinical success defined as successful implantation and freedom from aneurysm- or procedure-related death, secondary intervention, type I or III endoleak, infection, thrombosis, aneurysm expansion or rupture and conversion. secondary endpoints were radiological changes of the branched endograft (migration, shortening, scoliosis, lordosis, and fracture). results: after a median follow-up of 22.6 (LPSG) and 26.2 months (SPSG), no significant difference was found in terms of technical success (100% in both groups), late mortality (4.2% vs 0%), aneurysm diameter increase (4.2% in both groups) and reinterventions (25% vs 37.5%). Infection, thrombosis, aneurysm expansion or rupture and conversion were not observed. aradiological analysis of aortic graft remodeling showed no fracture and no significant migration, shortening, scoliosis and lordosis of the LPSG (6.1 mm, 7.5 mm, 12.8° and 6.1°) compared to SPSG (3.9 mm, 5.1 mm, 7.9° and 5.6°) after 2 years. conclusion: the clinical and radiological findings of the present study showed no increased mortality and complications for the matched patients who underwent treatment with low-profile vs standard-profile BEVAR. this study provides preliminary evidence of safety and efficacy of low-profile branched endografts in patients with demanding iliac access vessels.

Puta, B., Fazzini, S., Torsello, G., Pipitone, M.d., Austermann, M., Beropoulis, E., et al. (2021). Preliminary clinical and radiologic outcome of matched patients with thoracoabdominal aortic aneurysms treated by low-profile vs standard profile branched aortic endografts. ANNALS OF VASCULAR SURGERY, 75, 397-405 [10.1016/j.avsg.2021.01.095].

Preliminary clinical and radiologic outcome of matched patients with thoracoabdominal aortic aneurysms treated by low-profile vs standard profile branched aortic endografts

Fazzini, S.;
2021-01-01

Abstract

background: durability of low-profile branched aortic stent-grafts (LPSG) in the treatment of patients with thoracoabdominal aortic aneurysms (TAAA) remains unclear. objective of this study is to compare the outcomes of LPSG with standard profile branched aortic stent-grafts (SPSG). methods: between January 2016 and january 2020, 225 consecutive patients with TAAA were treated by branched endovascular aortic repair (BEVAR). twenty-four patients who were treated with a LPSG were compared to 24 patients who received SPSG as a control group. control patients were selected according to aneurysm size (maximum aneurysm diameter) and extension (Crawford classification) as well as availability of adequate preoperative and postoperative CT-angiograms at 24 months. the primary endpoint was ongoing clinical success defined as successful implantation and freedom from aneurysm- or procedure-related death, secondary intervention, type I or III endoleak, infection, thrombosis, aneurysm expansion or rupture and conversion. secondary endpoints were radiological changes of the branched endograft (migration, shortening, scoliosis, lordosis, and fracture). results: after a median follow-up of 22.6 (LPSG) and 26.2 months (SPSG), no significant difference was found in terms of technical success (100% in both groups), late mortality (4.2% vs 0%), aneurysm diameter increase (4.2% in both groups) and reinterventions (25% vs 37.5%). Infection, thrombosis, aneurysm expansion or rupture and conversion were not observed. aradiological analysis of aortic graft remodeling showed no fracture and no significant migration, shortening, scoliosis and lordosis of the LPSG (6.1 mm, 7.5 mm, 12.8° and 6.1°) compared to SPSG (3.9 mm, 5.1 mm, 7.9° and 5.6°) after 2 years. conclusion: the clinical and radiological findings of the present study showed no increased mortality and complications for the matched patients who underwent treatment with low-profile vs standard-profile BEVAR. this study provides preliminary evidence of safety and efficacy of low-profile branched endografts in patients with demanding iliac access vessels.
2021
Pubblicato
Rilevanza internazionale
Articolo
Esperti anonimi
Settore MED/22
Settore MEDS-13/B - Chirurgia vascolare
English
Aged ; Aortic Aneurysm, Thoracic ; Blood Vessel Prosthesis Implantation; Endovascular Procedures ;Female; Humans
Male; Middle Aged ; Postoperative Complications; Predictive Value of Tests ; Prosthesis Design ; Retrospective Studies
Risk Assessment ; Risk Factors ; Time Factors ; Treatment Outcome ; Aortography ; Blood Vessel Prosthesis ;
Computed Tomography Angiography ; Stents
Puta, B., Fazzini, S., Torsello, G., Pipitone, M.d., Austermann, M., Beropoulis, E., et al. (2021). Preliminary clinical and radiologic outcome of matched patients with thoracoabdominal aortic aneurysms treated by low-profile vs standard profile branched aortic endografts. ANNALS OF VASCULAR SURGERY, 75, 397-405 [10.1016/j.avsg.2021.01.095].
Puta, B; Fazzini, S; Torsello, G; Pipitone, Md; Austermann, M; Beropoulis, E; Torsello, Gf
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2108/387365
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