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Journal of Vascular Surgery
Article . 2021 . Peer-reviewed
License: Elsevier Non-Commercial
Data sources: Crossref
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CardioVascular and Interventional Radiology
Article . 2020 . Peer-reviewed
License: Springer TDM
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Thoracic Endovascular Aortic Repair in “Shaggy Thoracic Aortic Aneurysms”

Authors: Marco Franchin; Viviana Grassi; Gabriele Piffaretti; Ruth L. Bush; Matteo Tozzi; Chiara Lomazzi;

Thoracic Endovascular Aortic Repair in “Shaggy Thoracic Aortic Aneurysms”

Abstract

To report the outcomes of thoracic endovascular aortic repair (TEVAR) for shaggy thoracic aortic aneurysms (STA).It is a single center, retrospective, observational, cohort study. Data were collected prospectively between January 2005 and May 2019. STA was defined, based on computed tomography angiography findings, as the presence of an irregular/ulcerated atheroma protruding and/or thrombus thickness ≥ 5 mm protruding into the aortic lumen, and/or occupying more than two thirds of the circumference of the aortic diameter axially. Primary outcomes were early (≤ 30 days) and late survival and freedom from major complication due to end-organ or peripheral ischemic embolization.Nine (2.3%) of 391 patients met the inclusion criteria. Mean age was 71 years ± 10 (range 55-83). Mean aneurysm diameter was 68 mm ± 0.5 (range 60-75). Four patients presented symptomatic: rupture (n = 2), blue toe syndrome (n = 2). TEVAR was performed in 7 of the 9 patients. Operative-related embolization occurred in 1 patient (transient ischemic attack and acute kidney injury). In-hospital mortality was observed in 1 patient following spinal cord ischemia and multiple organ failure development. Median follow-up was 48 months (IQR 5-84). Freedom from major complication due to end-organ or peripheral ischemic embolization was achieved in all patients. No patient developed further localization of STA in the proximal or distal aorta, and did not experience reno-visceral or peripheral atheroembolization episodes.Risk of atheroembolism in STA is still threatening but TEVAR proved to be an effective and durable treatment in this high-risk cohort.

Keywords

Aged, 80 and over, Male, Time Factors, Aortic Aneurysm, Thoracic, Computed Tomography Angiography, Endovascular Procedures, Aorta, Thoracic, Middle Aged, Cohort Studies, Blood Vessel Prosthesis Implantation, Treatment Outcome, Risk Factors, Humans, Female, Hospital Mortality, Prospective Studies, Magnetic Resonance Angiography, Aged, Follow-Up Studies, Retrospective Studies

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    popularity
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    Top 10%
    influence
    This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
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    impulse
    This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
7
Top 10%
Top 10%
Top 10%
bronze