Abstract:
BACKGROUND:Endovascular treatment of thoracoabdominal aortic aneurysms is becoming increasingly popular in clinical practice, mainly because of its reduced perioperative mortality and morbidity. However, the custom-made stent graft platform that companies offer requires detailed preoperative planning and production time that can take up to 12 weeks. This may delay surgery in elective patients and is not an option for urgent or emergent cases. To surpass this limitation, the t-Branch (Cook Medical, Bloomington, Ind) was launched in 2012 in Europe as the first off-the-shelf standardized multibranched endograft for the endovascular treatment of thoracoabdominal aneurysms. Our aim was to systematically evaluate all published experience with this commercially available off-the-shelf thoracoabdominal stent graft. METHODS:We performed a systematic inquiry of the medical databases to identify all published studies that reported on the outcomes of patients treated with the t-Branch stent graft and then conducted a qualitative synthesis and meta-analysis of the results. The main end points studied were technical success, mortality, major stroke, spinal cord ischemia, primary branch patency, and renal insufficiency during the first 30 days along with midterm mortality and reintervention rate. We estimated pooled proportions and 95% confidence intervals (CIs). RESULTS:We identified seven retrospective studies published between 2014 and 2018, with a total of 197 patients (mean age, 72.3 ± 7 years; 70% male). Among 165 patients, 45% were symptomatic and 19% were treated for a ruptured aortic aneurysm. In 197 patients, pooled technical success was 92.75% (95% CI, 83.9%-98.7%), and in 10% of the cases, an early endoleak was detected (95% CI, 0%-43.7%). Early mortality was 5.8% (95% CI, 2.5%-10%), and major stroke was observed in 4% of the patients (95% CI, 0.96%-8.40%). The rate of spinal cord ischemia was 12.2% (95% CI, 4.1%-23.2%), with the rate of permanent paraplegia at 1.3% (95% CI, 0%-8.7%). Acute renal failure was 18.7% (95% CI, 9.1%-30.4%), whereas primary branch patency was calculated at 98.2% (95% CI, 96.7%-99.2%). Mean follow-up was 15 ± 7 months. During this time, midterm mortality (after 30 days) was 6.9% (95% CI, 2.44%-12.8%) and pooled reintervention rate was 5.7% (95% CI, 1.70%-11.4%). CONCLUSIONS:This pooled analysis indicated good technical success rate after t-Branch endograft implantation, with acceptable mortality and neurologic complications despite a high rate of urgent procedures. Thoracoabdominal endovascular repair with the t-Branch endograft is a feasible and safe therapeutic option for elective and urgent patients.
journal_name
J Vasc Surgjournal_title
Journal of vascular surgeryauthors
Konstantinou N,Antonopoulos CN,Jerkku T,Banafsche R,Kölbel T,Fiorucci B,Tsilimparis Ndoi
10.1016/j.jvs.2020.01.049subject
Has Abstractpub_date
2020-08-01 00:00:00pages
716-725.e1issue
2eissn
0741-5214issn
1097-6809pii
S0741-5214(20)30166-Xjournal_volume
72pub_type
杂志文章,meta分析abstract::The pedigrees were constructed of 43 patients (probands) who underwent resection of an abdominal aortic aneurysm. Seven probands (16.2%) had a first-degree relative (parent, sibling, child) known to have had an abdominal aortic aneurysm (multiplex family). To determine the prevalence of undiagnosed abdominal aortic an...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1991.25382
更新日期:1991-01-01 00:00:00
abstract::Tinnitus and hearing loss can occur in patients with a high-riding abnormal jugular bulb. Jugular vein ligation in selected patients can cure tinnitus and reverse hearing loss. A 39-year-old woman reported a 4-year history of right-sided tinnitus of increasing intensity associated with a mild hearing loss. Extensive e...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1987.avs0060248
更新日期:1987-09-01 00:00:00
abstract:OBJECTIVE:Median arcuate ligament syndrome (MALS) is an often overlooked, surgically correctable condition that mimics functional chronic abdominal pain. Patient-reported surgical outcomes are unpredictable in MALS. The objective of this study was to define the psychiatric comorbidities in a cohort of adults undergoing...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2017.12.078
更新日期:2018-11-01 00:00:00
abstract:OBJECTIVE:The Society for Vascular Surgery Wound, Ischemia, and foot Infection (WIfI) classification system has been validated to predict wound healing and limb salvage of patients with peripheral artery disease (PAD). Our goal was to evaluate the association between WIfI stage and wound healing, limb salvage, and surv...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2019.07.103
更新日期:2020-06-01 00:00:00
abstract::The Greenfield filter has become the most popular device for interruption of the inferior vena cava; however, a potential for lethal complications exists. We report two cases in which this filter was accidentally released in the heart. To avoid this problem, it is recommended that the guide wire be positioned in the i...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1987.avs0060609
更新日期:1987-12-01 00:00:00
abstract:OBJECTIVE:Aggressive endovascular interventions for patients without adequate full-length venous conduit have gained popularity. The purpose of this study is to evaluate the outcomes of spliced vein bypass (SVB) as primary treatment versus treatment after failed endovascular intervention (endovascular SVB [ESVB]) for i...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2019.05.055
更新日期:2020-03-01 00:00:00
abstract:INTRODUCTION:Thoracoabdominal aortic replacement requires visceral vessel revascularization and is usually performed with Crawford's inclusion technique or a large Carrel patch. This segment of retained native aorta may be prone to recurrent aneurysmal disease. We reviewed our experience with patients in whom aneurysma...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2001.117149
更新日期:2001-09-01 00:00:00
abstract:INTRODUCTION:Recent evidence suggests disparities exist among racial groups with peripheral arterial disease (PAD). Hispanics (HI) are the fastest growing demographic in the United States, but little outcome data is available for this population. Therefore, we undertook this study to compare the results of autogenous i...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2009.02.010
更新日期:2009-06-01 00:00:00
abstract:OBJECTIVE:Hostile infrarenal neck characteristics are associated with complications such as type Ia endoleak after endovascular aneurysm repair. Aortic neck angulation has been identified as one such characteristic, but its association with complications has not been uniform between studies. Neck angulation assumes tri...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jvs.2015.08.110
更新日期:2016-03-01 00:00:00
abstract:OBJECTIVE:Venoarterial extracorporeal membrane oxygenation (ECMO) is a salvage therapy in patients with severe cardiopulmonary failure. Owing to the large size of the cannulas inserted via the femoral vessels (≤24-F) required for adequate oxygenation, this procedure could result in significant limb ischemic complicatio...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2016.10.059
更新日期:2017-04-01 00:00:00
abstract:OBJECTIVE:Diabetes and peripheral arterial disease (PAD) are independently associated with increased risk of amputation. However, the effect of poor glycemic control on adverse limb events has not been studied. We examined the effects of poor glycemic control (high hemoglobin A1c level) on the risk of amputation and mo...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2017.06.101
更新日期:2018-01-01 00:00:00
abstract:INTRODUCTION:Despite its presumed effectiveness and clinical use, the physiology of selective visceral perfusion combined with distal aortic perfusion during open thoracoabdominal aortic surgery has not been characterized. Thus, the aim of this study was to establish a translatable model of thoracic aortic-clamping to ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2011.11.126
更新日期:2012-07-01 00:00:00
abstract:PURPOSE:No single method has been identified that accurately and reliably detects patients with impending bowel infarction during aortic reconstruction. Serial sampling of blood gas from the inferior mesenteric vein (IMV) for detecting colonic ischemia was compared with two previously described techniques: laser Dopple...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(95)70141-9
更新日期:1995-09-01 00:00:00
abstract:PURPOSE:Surgical revascularization of intestinal arteries is an effective long-term treatment for chronic intestinal ischemia (CII) regardless of the technique used. Conventional antegrade or retrograde bypass techniques are the most common modalities for extensive lesions that cannot be treated by endarterectomy or tr...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2004.12.031
更新日期:2005-03-01 00:00:00
abstract::True aneurysms of the pancreaticoduodenal artery are a rare form of visceral artery aneurysm. Two cases are presented and options for treatment are reviewed. ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/s0741-5214(96)80054-1
更新日期:1996-04-01 00:00:00
abstract::The literature contains conflicting reports about the potential value of the processed human umbilical vein graft as an arterial substitute. With a view to a better understanding of the ultimate fate of this device, a series of long-term implantation was undertaken with a nonhuman primate model. Dardik Biografts were ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1985.avs0020715
更新日期:1985-09-01 00:00:00
abstract:PURPOSE:The aim of this study was to present a 20-year experience with a single method of passive distal perfusion during descending thoracic aortic aneurysm resection. METHODS:Aortic repair with a Dacron graft interposition was performed for 366 consecutive aneurysms located between the left subclavian artery and the...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(95)70280-6
更新日期:1995-03-01 00:00:00
abstract:OBJECTIVE:Atherosclerotic peripheral arterial disease (PAD) is one of the most prevalent, morbid, and mortal diseases. The aim of this study was to evaluate mortality rates of patients with atherosclerotic PAD stratified according to age and diabetes and to determine predictors of death. METHODS:We studied 487 patient...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2013.11.063
更新日期:2014-05-01 00:00:00
abstract:PURPOSE:This study evaluated the values of transcutaneous oxygen tension (TcPo(2)) measurement in diabetic patients compared with nondiabetic patients and assessed its reproducibility. METHODS:In 60 diabetic patients (type 1 and type 2 diabetes mellitus) without signs of peripheral arterial disease or neuropathy, we m...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2008.03.010
更新日期:2008-08-01 00:00:00
abstract::During a 28-year period from 1955 to 1983, two cases of massive repetitive arterial thromboembolism from nonaneurysmal aortic mural thrombus were diagnosed antemortem and successfully corrected at the University of California, Los Angeles Medical Center. Within the same time period, 48 cases of nonaneurysmal aortic mu...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:
更新日期:1986-11-01 00:00:00
abstract::Clostridium septicum aortitis is a rare infection that has a strong association with occult colonic malignancy. To our knowledge, we report the 25th and 26th cases of C septicum aortitis in the English literature and make recommendations for its management. The first patient was a 75-year-old man who presented with ab...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jvs.2008.11.058
更新日期:2009-05-01 00:00:00
abstract:OBJECTIVE:We sought to determine the effects of renal insufficiency on thoracic endovascular aortic repair (TEVAR) outcome and to identify predictors for adverse events. METHODS:Eighty-four patients with renal insufficiency (creatinine >or=1.5 mg/dL) were analyzed from a prospective TEVAR database from April 1, 1999, ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2008.07.070
更新日期:2009-01-01 00:00:00
abstract:PURPOSE:External pneumatic compression (EPC) is an effective means of prophylaxis against deep venous thrombosis. However, its mechanism remains poorly understood. Understanding of the biological consequences of EPC is an important goal for optimizing performance of the EPC-generating device and providing guidance for ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2000.110357
更新日期:2000-11-01 00:00:00
abstract:BACKGROUND:In the era of rising endovascular treatment of thoracoabdominal aortic aneurysms (TAAAs), the analysis of visceral vessel (VV) patency after open surgical repair is crucial to provide a future benchmark between these different approaches. This study reports the late outcomes of a single-center experience wit...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2017.08.067
更新日期:2018-04-01 00:00:00
abstract:BACKGROUND:The study was conducted to demonstrate improved survival (30-day mortality) after the introduction of an emergency endovascular therapy protocol for ruptured abdominal aortic aneurysms (rAAA). Numerous authors have successfully demonstrated reduced mortality in patients with rAAA using endovascular technique...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2006.11.047
更新日期:2007-03-01 00:00:00
abstract:BACKGROUND:Peripheral arterial disease is a significant problem worldwide. In developing countries such as India, the increased incidence of smoking and other forms of nicotine intake has resulted in a large proportion of young individuals with Buerger's disease. The results of surgical and endovascular treatment for t...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2008.09.005
更新日期:2008-12-01 00:00:00
abstract::We report a case of successful surgical management of a potentially life-threatening complication of aortoiliac stent placement. A 59-year-old man who had Leriche syndrome underwent bilateral iliac artery and infrarenal aortic stent placement at another institution. His history was significant for retroperitoneal lymp...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(97)70007-7
更新日期:1997-12-01 00:00:00
abstract:BACKGROUND:Outcomes of revascularization for critical limb ischemia (CLI) have historically been patency, limb salvage, and survival. Functional status and quality of life have not been well described. This study used functional and quality of life assessments to measure patient-centered outcomes after revascularizatio...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2014.01.067
更新日期:2014-07-01 00:00:00
abstract:OBJECTIVES:The objectives of this study were to investigate variations between states and changes in state-specific carotid endarterectomy (CEA) and 30-day mortality rates. Cross-sectional variations and changes over time in such measures may be indicative of improvement in the quality of care. METHODS:We performed re...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(03)00616-5
更新日期:2003-10-01 00:00:00
abstract:OBJECTIVE:The primary purpose of the current study was to evaluate the safety and effectiveness of selective coverage of the left subclavian artery (LSCA) without revascularization during thoracic endovascular aortic repair (TEVAR) in patients with bilateral patent vertebrobasilar junctions. The secondary purpose was t...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2012.10.110
更新日期:2013-05-01 00:00:00