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Page 80
May 24-25, 2018
London, UK
Vascular Surgery 2018
3 rd Edition of World Congress & Exhibition on
Vascular Surgery
Journal of Vascular and Endovascular Therapy
ISSN: 2573-4482
Purpose: To evaluate the safety and efficacy of hybrid repair for
aortic lesions involving aortic arch.
Materials & Methods: From February 2009 to September 2016,
81 consecutive patients (70men; mean age 63.4±7.9 years, range
32-79) underwent brachiocephalic bypass combined with stent-
graft implantation (hybrid) and were enrolled in the study. Aortic
pathologies included Stanford type B aortic dissection (n=22),
aortic arch aneurysm (n=26), aortic arch pseudoaneurysm (n=14),
aortic arch penetrating ulcer (n=11) and proximal endoleak (n=5)
or pseudoaneurysm formation (n=3) after thoracic endovascular
aortic repair (TEVAR). Hybrid repair comprised 3 landing in zone
0, 44 landing in zone 1 and 34 landing in zone 2. Simultaneous
procedures included left subclavian artery embolization (n=57),
endovascular abdominal aortic repair (n=1), coronary artery
bypass (n=1), left commoncarotidendarterectomy (n=1) and renal
stenting (n=4). Follow-up was performed at 1 month, 3 months, 6
months, 1 year and annually thereafter to investigate endoleak,
patency of vascular graft and exclusion of aortic pathology.
Results: Technical success was 100%. Instant endoleak was
observed in 9 (11.1%, 7 type Ⅰ, 2 type Ⅱ) cases on postoperative
angiography. Perioperative complications included iatrogenic
ascending aortic dissection (n=1, 1.2%), stroke (n=2, 2.5%),
anastomotic bleeding (n=1, 1.2%), both lower limbs thrombosis
(n=1, 1.2%) and acute respiratory failure (n=2, 2.5%). Early
morbidity was 8.6% (7/81). Early death occurred in 5 cases (6.2%)
due to stroke, anastomotic bleeding, acute respiratory failure and
sudden death. Follow-up was complete in 100% for 39.4±14.5
months (range 1-81 months). During follow-up, all the vascular
grafts were patent. The overall endoleak rate was 13.58% (11/81).
Late mortality was 6.2% (5/81) and morbidity was 14.5% (8/81).
Conclusions: Hybrid repair of aortic pathologies involving aortic
arch is safe and effective with good short and mid-term results,
greatly expanding the indication of endovascular aortic repair.
Recent Publications
1. Xydas S, Mihos C G, Williams R F, et al. (2017) Hybrid
repair of aortic arch aneurysms: a comprehensive
review. J Thorac Dis, 9(Suppl 7):S629-S634.
2. Tadros R, Safir S R, Faries P L, et al. (2017) Hybrid repair
techniques for complex aneurysms and dissections
involving the aortic arch and thoracic aorta. SurgTechnol
Int, 30:243-247.
3. Pagliariccio G and Gatta E (2017) Rupture of a complex
aortic arch aneurysm: hybrid repair. Eur J Vasc Endovasc
Surg, 54(3):330.
4. Arnaoutakis G J and Szeto W Y (2016) Hybrid aortic arch
repair: The ultimate solution or a stop along the way
to a total endovascular arch reconstruction? J Thorac
Cardiovasc Surg, 152(1):169-170.
5. Faure E M, Canaud L, Marty Ane C, et al. (2016) Hybrid
aortic arch repair for dissecting aneurysm. J Thorac
Cardiovasc Surg, 152(1):162-168.
Biography
Yu Guo Xue is specialized on the diagnosis and interventional treatment
of aortic diseases, including dissection, intramural hematoma, penetrating
aortic ulcer, aneurysm, pseudoaneurysm and coarctation. Every year, more
than 300 patients with aortic diseases underwent endovascular treatment
at Beijing aortic diseases center.
Hybrid repair of aortic pathology involving aortic arch
Yu Guo Xue, Li Zhong Sun, Jun Zheng, Shangdong Xu and Lian Jun Huang
Beijing Aortic Diseases Center, China
Yu Guo Xue et al., J Vasc Endovasc Therapy 2018, Volume 3
DOI: 10.21767/2573-4482-C1-002