One-stage hybrid procedure for treating thoracic aortic pathologies that involve distal aortic arch
10.3760/cma.j.issn.1001-4497.2016.12.005
- VernacularTitle:主动脉覆膜支架置人并头臂血管转流术治疗累及远端主动脉弓的胸降主动脉病变
- Author:
Changwei REN
;
Xi GUO
;
Sheng YANG
;
Lizhong SUN
;
Lianjun HUANG
;
Yongqiang LAI
;
Shangdong XU
- Keywords:
Thoracic aortic pathologies involving distal aortic arch;
One-stage hybrid procedure;
Stent graft
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2016;32(12):728-730
- CountryChina
- Language:Chinese
-
Abstract:
Objective This study aims to evaluate the initial results of a hybrid procedure for treating descending thoracic aortic disease that involves distal aortic arch.It also intends to report our initial experience in performing this procedure.Methods A total of 45 patients(35 males and 10 females) with descending thoracic aortic disease underwent a hybrid procedure,namely,thoracic endovascular aortic repair(TEVAR) combined with supra-arch branch vessel bypass,in our center from April 2009 to August 2014.Right axillary artery to left axillary artery bypass(n =20) or right axillary artery to left common carotid artery and left axillary artery bypass(n =25) were performed.The conditions of all patients were followed up from the 14th month to the 77th month postoperative[mean(38.0 ± 17.1) months].Mortality within 30 days,complications such as endoleak after the hybrid procedure,and stenosis or blockage of the bypass graft during the follow-up period were assessed.Results One case of death and one case of cerebral infarction were reported within 30 days.Two patients underwent open surgery beacuse of endoleak.And a newly formed intimal tear was observed in one patient and the patient underwent a second TEVAR during the follow-up period.Condusion Initial results suggest that the one-stage hybrid procedure is a suitable therapeutic option for thoracic aortic pathologies that involve distal aortic arch.However,this procedure is not recommended for type-B aortic dissection,in which a tear is located in the greater curvature or near the left subclavian artery,because of the high possibility of endoleak occurrence.
