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.

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.

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

scholarly journals Risk Factors Predicting for Perioperative and Long-Term Mortality in Acute and Subacute Thoracic Endovascular Aortic Repair Patients

2021 ◽  
Vol 74 (3) ◽  
pp. e125
Author(s):  
Abhishek Rao ◽  
Ambar Mehta ◽  
Richard Schutzer ◽  
Danielle Bajakian ◽  
Nicholas Morrissey ◽  
...  
Keyword(s):  
Risk Factors ◽  
Thoracic Endovascular Aortic Repair ◽  
Endovascular Aortic Repair ◽  
Aortic Repair ◽  
Long Term Mortality

Long-Term Changes in Aortic Length after Thoracic Endovascular Aortic Repair

2016 ◽  
Vol 27 (2) ◽  
pp. 181-187 ◽  
Author(s):  
Nagy N.N. Naguib ◽  
Barbora Zima ◽  
Nour-Eldin A. Nour-Eldin ◽  
Tatjana Gruber-Rouh ◽  
Sebastian Fischer ◽  
...  
Keyword(s):  
Thoracic Endovascular Aortic Repair ◽  
Endovascular Aortic Repair ◽  
Aortic Repair ◽  
Long Term Changes

Long-Term Outcomes of Thoracic Endovascular Aortic Repair Focused on Bird Beak and Oversizing in Blunt Traumatic Thoracic Aortic Injury

2018 ◽  
Vol 50 ◽  
pp. 140-147 ◽  
Author(s):  
Marvin Ernesto García Reyes ◽  
Gabriela Gonçalves Martins ◽  
Valentín Fernández Valenzuela ◽  
José Manuel Domínguez González ◽  
Jordi Maeso Lebrun ◽  
...  
Keyword(s):  
Aortic Injury ◽  
Thoracic Endovascular Aortic Repair ◽  
Endovascular Aortic Repair ◽  
Long Term Outcomes ◽  
Aortic Repair ◽  
Thoracic Aortic Injury ◽  
Bird Beak

Outcomes of Thoracic Endovascular Aneurysm Repair (TEVAR) in Patients With Connective Tissue Disorders

2020 ◽  
Vol 54 (8) ◽  
pp. 676-680
Author(s):  
Khalil Qato ◽  
Allan Conway ◽  
Eileen Lu ◽  
Nhan Nguyen Tran ◽  
Gary Giangola ◽  
...  
Keyword(s):  
Connective Tissue ◽  
Thoracic Endovascular Aortic Repair ◽  
Endovascular Aortic Repair ◽  
Acute Type ◽  
Type B ◽  
Connective Tissue Disorders ◽  
Aortic Repair ◽  
Type B Dissection ◽  
Significant Difference

Objectives: Thoracic endovascular aortic repair (TEVAR) remains controversial in patients with connective tissue disorders given the concern for durability. We report on the largest series to date on outcomes of patients with thoracic aortic disease and connective tissue disorders treated with TEVAR. Methods: The Vascular Quality Initiative registry identified 12 207 patients treated with TEVAR from January 2010 to December 2018, including 102 with Marfans, Ehlers-Danlos, or Loey-Dietz syndrome. Outcomes were analyzed per the Society for Vascular Surgery reporting standards. Results: Median age was 50.6 years (interquartile range: 57.0-75.0), and 62 (60.7%) were male. Eighty-eight (86.3%) patients had Marfan, 9 (8.8%) had Ehlers-Danlos, and 5 (4.9%) had Loey-Dietz syndrome. Twenty-six (25.5%) patients were treated for degenerative aneurysmal disease and 76 (74.5%) patients for type B dissections (33 acute, 31 chronic). Most common indications for interventions in patients with type B dissection were pain (n = 41), aneurysmal degeneration (n = 16), and malperfusion (n = 8), with 3 patients who presented ruptured. There was no significant difference in perioperative complications between acute/chronic dissections and aneurysms ( P = .14). Percutaneous access was utilized in 61.7% of patients, with a 2.9% rate of arterial injury requiring reintervention. Follow-up data were available for 75 (73.3%) patients at a mean follow-up of 15.6 months. Overall mortality was 5.3%. There were 30 patients with follow-up endoleak data, and 8 (26.7%) endoleaks were identified. All endoleaks were in patients treated for acute type B dissection, and all resolved after a mean of 2.1 reinterventions. Three patients treated for acute Type B Aortic Dissection (TBAD) had retrograde dissections requiring intervention. Discussion: Thoracic endovascular aortic repair for patients with connective tissue disorders can be performed with low perioperative mortality, spinal cord ischemia, or Cerebrovascular Accident (CVA). On follow-up, acute type B aortic dissections represent a higher risk subgroup with increased rates of endoleak and retrograde dissection. Closer follow-up for these patients and early reintervention may be beneficial.

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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