European Multicenter Registry for the Performance of the Chimney/Snorkel Technique in the Treatment of Aortic Arch Pathologic Conditions.
- Bosiers MJ Department of Vascular and Endovascular Surgery, University of Münster, Münster; Department of Vascular Surgery, St. Franziskus-Hospital Münster, Münster, Germany.
- Donas KP Department of Vascular and Endovascular Surgery, University of Münster, Münster; Department of Vascular Surgery, St. Franziskus-Hospital Münster, Münster, Germany. Electronic address: konstantinos.donas@googlemail.com.
- Mangialardi N Department of Vascular Surgery, San Filippo Neri Hospital, Rome, Italy.
- Torsello G Department of Vascular and Endovascular Surgery, University of Münster, Münster; Department of Vascular Surgery, St. Franziskus-Hospital Münster, Münster, Germany.
- Riambau V Vascular Access Unit, Vascular Surgery Division, Thorax Institute, Hospital Clínic, University of Barcelona, Barcelona, Spain.
- Criado FJ Division of Vascular Surgery, MedStar Union Memorial Hospital, Baltimore, Maryland.
- Veith FJ Division of Vascular Surgery, New York University Langone Medical Center, New York, New York; Department of Vascular Surgery, The Cleveland Clinic, Cleveland, Ohio.
- Ronchey S Department of Vascular Surgery, San Filippo Neri Hospital, Rome, Italy.
- Fazzini S Department of Vascular Surgery, San Filippo Neri Hospital, Rome, Italy.
- Lachat M Clinic for Cardiovascular Surgery, University Hospital Zurich, Switzerland.
- 2016-01-23
Published in:
- The Annals of thoracic surgery. - 2016
Adult
Aged
Aorta, Thoracic
Aortic Diseases
Aortography
Blood Vessel Prosthesis
Blood Vessel Prosthesis Implantation
Cohort Studies
Computed Tomography Angiography
Elective Surgical Procedures
Emergency Treatment
Endoleak
Endovascular Procedures
Female
Follow-Up Studies
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Prosthesis Design
Registries
Retrospective Studies
Risk Assessment
Statistics, Nonparametric
Survival Analysis
Treatment Outcome
Young Adult
English
BACKGROUND
To study the performance of the chimney technique in the treatment of aortic arch pathologic conditions.
METHODS
We retrospectively evaluated the clinical and procedural outcome data of patients undergoing endovascular treatment in the aortic arch by use of the chimney technique at four European centers between June 2002 and December 2014. The primary endpoint was technical success. The secondary endpoints were type I endoleak, 30-day mortality, stroke, primary patency of the chimney graft, and freedom from reintervention.
RESULTS
Ninety-five patients were included in the study. The underlying pathologic conditions were degenerative aneurysm (n = 45, 47.4%), type B aortic dissection (n = 30, 31.6%), dissecting aneurysm (n = 6, 6.5%), penetrating atherosclerotic ulcer (n = 5, 5.3%), type I endoleak after previous thoracic endovascular aortic repair (n = 6, 6.3%), and aortic embolic disease (n = 3, 3.2%). Twenty-one patients (22%) underwent arch-branch debranching before chimney graft implantation. The majority of patients were treated electively (n = 49, 51.6%). Forty-six patients (48.4%) underwent urgent placement of chimney grafts because of their symptoms (n = 25) or rupture (n = 21). Technical success was 89.5%. The 30-day mortality was 9.5% (9 patients). No aorta-related death was observed. A type Ia endoleak occurred in 10 patients (10.5%) intraoperatively, resolving spontaneously within the first 30 days in 50% of these cases. Major stroke was diagnosed in 2 patients (2%). Primary patency of the chimney grafts was 98%, and 5 patients (5.2%) required a reintervention.
CONCLUSIONS
The chimney technique in the aortic arch proved highly and predictably successful, with a low rate of reinterventions.
To study the performance of the chimney technique in the treatment of aortic arch pathologic conditions.
METHODS
We retrospectively evaluated the clinical and procedural outcome data of patients undergoing endovascular treatment in the aortic arch by use of the chimney technique at four European centers between June 2002 and December 2014. The primary endpoint was technical success. The secondary endpoints were type I endoleak, 30-day mortality, stroke, primary patency of the chimney graft, and freedom from reintervention.
RESULTS
Ninety-five patients were included in the study. The underlying pathologic conditions were degenerative aneurysm (n = 45, 47.4%), type B aortic dissection (n = 30, 31.6%), dissecting aneurysm (n = 6, 6.5%), penetrating atherosclerotic ulcer (n = 5, 5.3%), type I endoleak after previous thoracic endovascular aortic repair (n = 6, 6.3%), and aortic embolic disease (n = 3, 3.2%). Twenty-one patients (22%) underwent arch-branch debranching before chimney graft implantation. The majority of patients were treated electively (n = 49, 51.6%). Forty-six patients (48.4%) underwent urgent placement of chimney grafts because of their symptoms (n = 25) or rupture (n = 21). Technical success was 89.5%. The 30-day mortality was 9.5% (9 patients). No aorta-related death was observed. A type Ia endoleak occurred in 10 patients (10.5%) intraoperatively, resolving spontaneously within the first 30 days in 50% of these cases. Major stroke was diagnosed in 2 patients (2%). Primary patency of the chimney grafts was 98%, and 5 patients (5.2%) required a reintervention.
CONCLUSIONS
The chimney technique in the aortic arch proved highly and predictably successful, with a low rate of reinterventions.
- Language
-
- English
- Open access status
- bronze
- Identifiers
-
- DOI 10.1016/j.athoracsur.2015.10.112
- PMID 26794885
- Persistent URL
- https://sonar.rero.ch/global/documents/287305
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