Long-Term Patency of Visceral Vessels After Thoracoabdominal Aortic Repair
Open repair of thoracoabdominal aortic aneurysms (TAAAs) is an extraordinary challenge for both vascular surgeons and patients. Consistent outcome data have been reported by high-volume centers with 30-day mortality rates lower than 10% and improved long-term survivals . The development of devices and techniques have allowed total endovascular treatment of TAAA with fenestrated (FEVAR) or branched (BEVAR) endografts [2–6]. Early results are encouraging; a recent meta-analysis has reported a 30-day mortality rate of 8.6%, spinal cord ischemia in 17.3% of cases with permanent consequences in 4.9%, and renal failure in 25.4%. However, anatomic feasibility of BEVAR/FEVAR is still limited, manufacturing times for custom devices are lengthy, and open repair remains the only viable strategy in a number of specific conditions, such as emergency cases, infections, and patients affected by connective tissue disorders.
- 7.Verzini F, Loschi D, De Rango P, Ferrer C, Simonte G, Coscarella C, et al. Current results of total endovascular repair of thoracoabdominal aortic aneurysms. J Cardiovasc Surg. 2014;55:9–19.Google Scholar
- 15.National Kidney Foundation. K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Am J Kidney Dis. 2002;39(suppl.1):S1–266.Google Scholar
- 18.Lin PH, Kougias P, Bechara CF, Wakley SM, Bakaeen FG, Lemaire SA, et al. Clinical outcome of staged versus combined treatment approach of hybrid repair of thoracoabdominal aortic aneurysm with visceral vessel debranching and aortic endograft exclusion. Perspect Vasc Surg Endovasc Ther. 2012;24:5–13.CrossRefGoogle Scholar