Repair of type Ⅰa endoleak after thoracic endovascular aortic repair
10.7507/1007-4848.201804020
- VernacularTitle:胸主动脉腔内修复术术后近端内漏的治疗
- Author:
LI Chengnan
1
,
2
;
ZHU Junming
1
,
2
;
QI Ruidong
1
,
2
;
YANG Yi
1
,
2
;
YU Hai
1
,
2
;
XING Xiaoyan
1
,
2
;
LIU Yongmin
1
,
2
;
HUANG Lianjun
1
,
2
;
SUN Lizhong
1
,
2
Author Information
1. Anzhen Beijing Aortic Disease Center, Beijing Institute of Heart, Lung and Blood Vessel Diseases &
2. Beijing Hospital, Capital Medical University, Beijing, 100029, P.R.China
- Publication Type:Journal Article
- Keywords:
Type Ⅰa endoleak;
thoracic endovascular aortic repair;
hybrid aortic arch repair;
Sun's procedure;
stented elephant trunk procedure;
cuff extension
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2018;25(10):870-874
- CountryChina
- Language:Chinese
-
Abstract:
Objective To retrospectively review our experience of correction of type Ⅰa endoleak after thoracic endovascular aortic repair(TEVAR). Methods From August 2009 to May 2016, 29 patients with type Ⅰa endoleak after TEVAR (25 males, 4 females at mean age of 56±10 years (range, 41–86 years) underwent treatment: open surgery in 15 patients (an open surgery group), hybrid aortic arch repair in 6 patients (a hybrid group) and cuff extension in 8 patients(a cuff group). A history of hypertension was noted in 25 patients, diabetes mellitus in 3 patients, coronary artery disease in 3 patients, lung infection in one patient, aortic root aneurysm in one patient and aberrant right subclavian artery in one patient. Results In the open surgery group, no death was observed. Continuous renal replacement therapy and re-intubation was done in one patient and drainage of pericardial effusion in one patient. No death was noted in the hybrid group and persistent type Ⅰa endoleak in one patient. In the cuff group, thrombosis of the left common artery was noted in one patient and bypass of the left axillary artery to the left axillary artery and the left common carotid artery was done. Unfortunately, he died of cerebral infarction and total in-hospital death rate was 3.4% (1/29). Bypass of the left axillary artery to the left axillary artery was done in one patient with left upper limb ischemia. There were 4 (14.2%) deaths during follow-up: 3 deaths in the open surgical group and one death in the cuff group. Endoleak was observed in one patient in the hybrid group and one in the cuff group. Conclusion The corresponding procedure, including open surgery, hybrid aortic arch repair or cuff extension, is scheduled to be done according to the characteristics of type Ⅰa endoleak. Satisfactory outcomes are achieved in patients with typeⅠa endoleak.
