P22 PRELIMINARY EXPERIENCE WITH PROPHYLACTIC THORACIC ENDOVASCULAR AORTIC REPAIR (PRO-TEAVAR) IN PATIENTS AFFECTED BY ADVANCED ESOPHAGEAL CANCER

2019 ◽  
Vol 32 (Supplement_2) ◽  
Author(s):  
Maria Clelia Gervasi ◽  
Carlo Alberto De Pasqual ◽  
Jacopo Weindelmayer ◽  
Luca Mezzetto ◽  
Lorenzo Scrsone ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Thoracic Aorta ◽  
Aortic Wall ◽  
Tertiary Hospital ◽  
Thoracic Endovascular Aortic Repair ◽  
Endovascular Aortic Repair ◽  
Invasive Technique ◽  
Esophageal Fistula ◽  
Advanced Esophageal Cancer ◽  
Aortic Repair

Abstract Bleeding from the thoracic aorta is potentially fatal in patients with advanced esophageal cancer (AEC). Esophageal malignancy is the third most common cause of aorto-esophageal fistula (AEF), after thoracic aortic aneurysm and ingestion of foreign body. The involvement of aortic wall often contraindicates chemo-radiotherapy (CRT) treatment, thus reducing life expectancy of these patients. Thoracic endovascular aortic repair (TEVAR) is a well described mini-invasive technique that can be also applied for coverage of aortic lumen in case of invasion by esophageal cancer (EC). Only few cases have been published with this atypical indication. Between 2016 and 2018, in our tertiary hospital three patients affected by AEC involving the thoracic aorta were treated by means of prophylactic TEVAR (ProTEVAR). We did not observe procedure-related complications and all patients were reconsidered fit for preoperative or definitive CRT.

Evaluation of EndoAnchor Aortic Wall Penetration After Thoracic Endovascular Aortic Repair

2020 ◽  
Vol 27 (2) ◽  
pp. 240-247
Author(s):  
Andrés Reyes Valdivia ◽  
Sara Busto Suárez ◽  
África Duque Santos ◽  
Ahmad Amer Zanabili Al-Sibbai ◽  
Claudio Gandarias Zúñiga ◽  
...  
Keyword(s):  
Thoracic Aorta ◽  
Aortic Wall ◽  
Thoracic Endovascular Aortic Repair ◽  
Endovascular Aortic Repair ◽  
Descending Thoracic Aorta ◽  
Aortic Repair ◽  
Type Ia ◽  
Endograft Infection ◽  
Academic Vascular Surgery

Purpose: To analyze aortic wall penetration of Heli-FX EndoAnchors after use in seal zones in the aortic arch or descending thoracic aorta during thoracic endovascular aortic repair (TEVAR). Materials and Methods: From May 2014 to May 2019, 25 patients (mean age 70.5±10 years; 16 women) were treated with TEVAR and adjunctive use of the Heli-FX device in 3 academic vascular surgery departments. Computed tomography scans were retrospectively reviewed to determine the location [arch or descending thoracic aorta (DTA)] of the EndoAnchors and the adequacy of aortic wall penetration, defined as adequate (≥2 mm), partial (<2 mm), or inadequate wall penetration (including loss). Endoleaks, reinterventions, and mortality were assessed. Results: A total of 161 EndoAnchors were deployed (median 7 per patient, range 4–9). Twenty-two EndoAnchors were place in the arch (zones 0–2) and 139 in the DTA (zones 3–5). A larger proportion of arch deployments (27%) had suboptimal penetration compared with the DTA (6.5%; p<0.005), resulting in a 91% adequate wall penetration rate for the series overall. Three EndoAnchors were lost (and only 1 retrieved) in 3 different patients, with no additional morbidity; thus, an overall deployment success rate of 88% was achieved. At a mean follow-up of 16.6±14 months, 4 patients required 5 (successful) reinterventions, including one for a type Ia endoleak treated with chimney TEVAR. One patient died 10 months after treatment due to endograft infection, without an opportunity for surgical correction. Conclusion: EndoAnchors have a higher risk of maldeployment in the arch, though this may be attributable to the small learning curve experience in this location. The best aortic wall penetration for this series was in the DTA, where EndoAnchors proved useful for distal endograft fixation during TEVAR.

Thoracic endovascular aortic repair for esophageal cancer invading the thoracic aorta: a questionnaire survey study

Esophagus ◽  
2019 ◽  
Vol 17 (1) ◽  
pp. 74-80
Author(s):  
Masayuki Watanabe ◽  
Masanobu Nakajima ◽  
Katsunori Nishikawa ◽  
Hiroyuki Kato ◽  
Hisahiro Matsubara
Keyword(s):  
Esophageal Cancer ◽  
Thoracic Aorta ◽  
Questionnaire Survey ◽  
Thoracic Endovascular Aortic Repair ◽  
Endovascular Aortic Repair ◽  
Survey Study ◽  
Aortic Repair

scholarly journals The Long-Term Clinical Impact of Thoracic Endovascular Aortic Repair (TEVAR) for Advanced Esophageal Cancer Invading Aorta

2021 ◽  
Author(s):  
Ke-Cheng Chen ◽  
I-Hui Wu ◽  
Chih-Yang Chang ◽  
Pei-Ming Huang ◽  
Mong-Wei Lin ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Multimodality Treatment ◽  
Thoracic Endovascular Aortic Repair ◽  
Clinical Impact ◽  
Endovascular Aortic Repair ◽  
Advanced Esophageal Cancer ◽  
Local Tumor ◽  
Aortic Repair ◽  
Significant Difference

Abstract Background Advanced esophageal cancer invading the aorta is considered unsuitable for surgery with definitive chemotherapy or chemoradiation as the treatments of choice. In the current study, we evaluated the long-term clinical impact of combining thoracic endovascular aortic repair (TEVAR) with multimodality treatment in caring for such patients. Methods We evaluated 48 patients who had advanced esophageal cancer with aortic invasion. The oncological outcome, including overall survival (OS) and progression-free survival (PFS), after multimodality treatment with or without TEVAR is evaluated for these patients. Results Overall, 25/48 patients (52.1%) received a TEVAR procedure. There was no significant difference in OS (p = 0.223) between patients who did or did not receive TEVAR; however, patients who received TEVAR had significantly less local tumor recurrence (p = 0.020) and longer PFS (p = 0.019). This impact was most evident in patients who received both TEVAR and esophagectomy, with an incremental increase in hazard ratio (HR) for disease progression of 2.89 (95% confidence interval [CI] 0.86–9.96) and 4.37 (95% CI 1.33–14.33) observed under multivariable analysis, respectively, in comparison with patients who underwent only one or neither of these procedures (p = 0.005 for trend test). Conclusion TEVAR is a feasible procedure for esophageal cancers invading the aorta and can be used for curative-intent resection to improve local tumor control and PFS.

Preliminary Experience with Prophylactic Thoracic Endovascular Aortic Repair in Patients Affected by Advanced Esophageal Cancer

2019 ◽  
Vol 61 ◽  
pp. 142-147
Author(s):  
Luca Mezzetto ◽  
Lorenzo Scorsone ◽  
Carlo Alberto De Pasqual ◽  
Jacopo Weindelmayer ◽  
Simone Giacopuzzi ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Thoracic Endovascular Aortic Repair ◽  
Endovascular Aortic Repair ◽  
Advanced Esophageal Cancer ◽  
Aortic Repair

Aortic Arch and Thoracic Aorta Curvature Remodeling after Thoracic Endovascular Aortic Repair

2017 ◽  
Vol 38 ◽  
pp. 233-241 ◽  
Author(s):  
Gaspar Mestres ◽  
Marvin E. Garcia ◽  
Xavier Yugueros ◽  
Rodrigo Urrea ◽  
Paolo Tripodi ◽  
...  
Keyword(s):  
Aortic Arch ◽  
Thoracic Aorta ◽  
Thoracic Endovascular Aortic Repair ◽  
Endovascular Aortic Repair ◽  
Aortic Repair

Back stabber: ladder fall causing traumatic aortic transection

2019 ◽  
Vol 27 (4) ◽  
pp. 302-303
Author(s):  
Babatunde A Yerokun ◽  
Jatin Anand ◽  
Richard L McCann ◽  
G Chad Hughes
Keyword(s):  
Back Pain ◽  
Spinal Fusion ◽  
Aortic Wall ◽  
Excellent Result ◽  
Aortic Injury ◽  
Thoracic Endovascular Aortic Repair ◽  
Endovascular Aortic Repair ◽  
Thoracic Vertebrae ◽  
Aortic Repair ◽  
Aortic Transection

A 68-year-old man presented with back pain after falling from a ladder and was found to have anterolisthesis of thoracic vertebrae T11-12 with secondary focal aortic injury and disruption of the aortic wall. This was successfully repaired using thoracic endovascular aortic repair (TEVAR) followed by spinal fusion with excellent result.

scholarly journals Thoracic Endovascular Aortic Repair of Esophageal Cancer-Associated Aortoesophageal Fistula: A Case Report and Literature Review

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Akiko Sasaki ◽  
Hideto Egashira ◽  
Shinnosuke Tokoro ◽  
Chikamasa Ichita ◽  
Satoshi Takizawa ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Stent Graft ◽  
Postoperative Management ◽  
Thoracic Endovascular Aortic Repair ◽  
Endovascular Aortic Repair ◽  
Stent Insertion ◽  
Aortoesophageal Fistula ◽  
Bridge To Surgery ◽  
Aortic Repair ◽  
T4 Esophageal Cancer

Background. Thoracic endovascular aortic repair of an aortoesophageal fistula is an effective emergency treatment for patients with T4-esophageal cancer, as it prevents sudden death, and is a bridge to surgery. However, the course of unresectable malignant aortoesophageal fistula treated with thoracic endovascular aortic repair alone is not well-known. Case Presentation. We report a 67-year-old Japanese man with T4-esophageal cancer who experienced a chemoradiation-induced aortoesophageal fistula and was rescued with thoracic endovascular aortic repair. He recovered after the procedure and survived for 4 additional months with management of a mycotic aneurysm and secondary aortoesophageal fistula with the exposure of the stent graft into the esophagus. Thoracic endovascular aortic repair of aortoesophageal fistula with T4-esophageal cancer extended life for nearly an average of 4 months in the reported cases. As a postoperative complication, the exposure of the stent graft into the esophagus is rare but life-threatening; the esophageal stent insertion was effective. Conclusions. With postoperative management advances, thoracic endovascular aortic repair can improve survival and increase the quality of life of patients with T4-esophageal cancer.

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