scholarly journals Various Endoluminal Approaches Available for Treating Pathologies of the Aortic Arch

2020 ◽  
Vol 43 (12) ◽  
pp. 1756-1769
Author(s):  
Muzaffar A. Anwar ◽  
Mohammad Hamady
Keyword(s):  
Aortic Arch ◽  
Surgical Repair ◽  
Hybrid Approach ◽  
Aortic Disease ◽  
Open Surgical Repair ◽  
Neurological Sequelae ◽  
Aortic Stent Graft ◽  
Custom Made ◽  
Term Data

Abstract Open surgical repair of the aortic arch for degenerative aortic disease in an unfit patient is associated with significant morbidity and mortality. Endoluminal techniques have advanced over the last decade. Contemporary endovascular options including a hybrid approach (supra-aortic debranching and aortic stent graft), inner branched endograft, chimney stents, and scallop or fenestrated endografts are being used frequently as an alternative to open surgical arch repair. Understanding of the available endoluminal technology along with careful planning and effective teamwork is required to minimise complications associated with the endoluminal techniques, particularly neurological ones. Custom made techniques are superior to chimney or parallel technology in terms of their complications and durability. Integration of the protective devices such as embolic protection filters into stent design may reduce the risk of poor neurological sequelae. Long-term data are needed to assess the durability of these devices.

Comparison of hybrid endovascular and open surgical repair for proximal aortic arch diseases

2016 ◽  
Vol 203 ◽  
pp. 975-979 ◽  
Author(s):  
Woong Chol Kang ◽  
Young-Guk Ko ◽  
Eak Kyun Shin ◽  
Chul-Hyun Park ◽  
Donghoon Choi ◽  
...  
Keyword(s):  
Aortic Arch ◽  
Surgical Repair ◽  
Open Surgical Repair

Long-Term Results of Surgical Treatment of Popliteal Artery Aneurysms

2016 ◽  
Vol 103 (5-6) ◽  
pp. 315-322
Author(s):  
Kimihiro Igari ◽  
Toshifumi Kudo ◽  
Takahiro Toyofuku ◽  
Takehisa Iwai ◽  
Yoshinori Inoue
Keyword(s):  
Limb Salvage ◽  
Popliteal Artery ◽  
Surgical Repair ◽  
Graft Patency ◽  
Primary Patency ◽  
Long Term Results ◽  
Open Surgical Repair ◽  
Autologous Vein ◽  
Medial Approach

The aim of this study was to evaluate the long-term outcomes of the surgical repair of popliteal artery aneurysms (PAAs), and to analyze the factors associated with graft patency. Between January 1980 and December 2013, 45 limbs were subjected to open surgical repair at Tokyo Medical and Dental Hospital. We retrospectively examined the patients' clinical characteristics, clinical symptoms, and aneurysm-related anatomy. Surgical procedures were performed through a posterior or medial approach using autologous vein or prosthetic graft. Surgical outcomes were evaluated by postoperative mortality, postoperative morbidity, graft patency, and limb salvage. During the study period, 45 limbs (35 patients; mean age, 60 years) underwent open surgical repair. A total of 25 limbs were treated through a posterior approach using 23 autologous vein grafts (AVGs) and 2 expanded polytetrafluoroethylene (ePTFE) grafts. The other 20 limbs were treated through a medial approach using 13 AVGs and 7 ePTFE grafts. During the mean follow-up period of 65 months, the primary patency rates at 1, 3, and 5 years were 88.0%, 75.7%, and 75.7%, respectively, and the limb salvage rates at 1, 3, and 5 years were 97.1%, 91.4%, and 91.4%, respectively. In the univariate analysis, the ligation and bypass grafting affected the primary patency rate significantly, and the ePTFE graft was associated with a poor primary patency in the multivariate analysis (hazard ratio, 17.8). The use of resection or endoaneurysmorrhaphy for PAAs and graft interposition with an AVG might be more effective for the open repair of PAAs.

scholarly journals Early and mid-term outcomes of endovascular and open surgical repair of non-dissected aortic arch aneurysm†

2017 ◽  
Vol 24 (6) ◽  
pp. 944-950 ◽  
Author(s):  
Daijiro Hori ◽  
Homare Okamura ◽  
Takahiro Yamamoto ◽  
Satoshi Nishi ◽  
Koichi Yuri ◽  
...  
Keyword(s):  
Aortic Arch ◽  
Surgical Repair ◽  
Aortic Arch Aneurysm ◽  
Open Surgical Repair ◽  
Arch Aneurysm

Long-Term Outcomes of Open Surgical Repair for Ruptured Iliac Artery Aneurysms

2011 ◽  
Vol 25 (6) ◽  
pp. 740-747 ◽  
Author(s):  
Hiroshi Yamamoto ◽  
Fumio Yamamoto ◽  
Kazuyuki Ishibashi ◽  
Ke-Xiang Liu ◽  
Gembu Yamaura ◽  
...  
Keyword(s):  
Iliac Artery ◽  
Surgical Repair ◽  
Long Term Outcomes ◽  
Open Surgical Repair

scholarly journals Effectiveness of Repair of Aortic Coarctation in Neonates: A Long-Term experience

2021 ◽  
Author(s):  
Chiara Minotti ◽  
Manuela Scioni ◽  
Biagio Castaldi ◽  
Alvise Guariento ◽  
Roberta Biffanti ◽  
...  
Keyword(s):  
Aortic Arch ◽  
Aortic Coarctation ◽  
Surgical Repair ◽  
Nyha Class ◽  
Long Term Results ◽  
Relative Risk Ratio ◽  
Hypoplastic Aortic Arch ◽  
Long Term Experience

AbstractTo evaluate early and long-term results of surgical treatment of aortic coarctation (CoAo) in neonates. This is a retrospective clinical review of neonates with CoAo, who underwent surgery between 1995 and 2019. Data were retrieved from our institutional database, to identify preoperative and postoperative characteristics. Statistical analysis was performed by means of relative risk ratio and Cox and logistic multivariate analysis. 218 consecutive neonates (M/F: 129/89, median age 11 days, IQR 7–17 days) were included; 202 (92.7%) had a left thoracotomy; 178 underwent extended end-to-end anastomosis (EEEA, 81.6%). Hypoplastic aortic arch (HAA) was present in 102 patients (46.8%); complex cardiac anomalies in 85 (39%). Significant postoperative complications occurred in 20 (9.2%). Thirty-day mortality was 2.3% (most in complex types). At a median follow-up of 10.4 years (IQR 5.6–15.0 years; FU completeness 95.9%), there were 8 late deaths (3.7%), all associated to complex CoAo. Among 196 survivors, 177 (93.2%) were in NYHA class I; re-interventions on aortic arch occurred in 9.2% (2.0% were surgical). Freedom from mortality and re-intervention on aorta at 10 years were 94.3% and 96.7%, respectively. Surgical repair of CoAo in newborns without CPB in our series was safe and low-risk, with excellent early and late outcomes.

scholarly journals Outcomes of Open Surgical Repair of Descending Thoracic Aortic Disease

2014 ◽  
Vol 47 (3) ◽  
pp. 255-261
Author(s):  
Won-Young Lee ◽  
Jae Suk Yoo ◽  
Joon Bum Kim ◽  
Sung-Ho Jung ◽  
Suk Jung Choo ◽  
...  
Keyword(s):  
Surgical Repair ◽  
Aortic Disease ◽  
Open Surgical Repair ◽  
Thoracic Aortic Disease

Clinical outcome of acute thoracic aortic syndrome in nonagenarians

2020 ◽  
Vol 28 (9) ◽  
pp. 577-582
Author(s):  
Mamoru Arakawa ◽  
Homare Okamura ◽  
Atsushi Miyagawa ◽  
Yuichiro Kitada ◽  
Hideo Adachi
Keyword(s):  
Decision Making ◽  
Thoracic Aorta ◽  
Surgical Repair ◽  
Survival Rates ◽  
Median Sternotomy ◽  
Aortic Disease ◽  
Open Surgical Repair ◽  
Clinical Frailty Scale ◽  
The Mean ◽  
Surgical Group

Background Decision-making regarding the operability of thoracic aortic disease in nonagenarian patients remains controversial because outcomes of open surgical repair of the thoracic aorta are unclear. We investigated the surgical and nonsurgical outcomes of acute thoracic aortic syndrome treatment in nonagenarians. Methods After evaluating data in our institute from April 2016 to March 2020, we included 10 nonagenarians who needed surgical intervention on the thoracic aorta via a median sternotomy for acute thoracic aortic syndrome. The mean age of the cohort was 91.9 ± 2.1 years. Five patients underwent open surgical repair of the thoracic aorta (surgical group), and 5 refused surgery (nonsurgical group). All patients in the surgical group performed activities of daily living independently, with a mean clinical frailty scale of 3.2 ± 0.4. The surgical group included 4 patients with type A aortic dissection and one with a ruptured thoracic aortic aneurysm. Hemiarch replacement was performed in 3 patients and total arch replacement in 2. The mean follow-up period was 17.8 ± 5.1 months. Results Hospital mortality rates were 0% in the surgical and 80% in the nonsurgical group. The mean length of hospitalization was 28.4 ± 6.7 days in the surgical group. The 1-year survival rates were 100% in the surgical group and 20% in the nonsurgical group. Conclusion Open surgical repair for acute thoracic aortic syndrome via median sternotomy is a reasonable treatment option even in nonagenarians. Involvement of family members is important for decision-making to devise the optimal treatment strategy (surgical vs. medical).

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