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The Current Status of Hybrid Repair of Thoracoabdominal Aortic Aneurysms

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Peripheral Endovascular Interventions

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Abstract

The management of thoracoabdominal aortic aneurysms (TAAA) remains a significant challenge for vascular and cardiovascular specialists involved in the treatment of complex aortic disease. Until recently, open repair with visceral and intercostal reimplantation, along with adjunctive measures to decrease the incidence of spinal chord ischemia, was the only interventional option available to treat these patients (Fig. 26.1). The commercial availability of thoracic aortic stent grafts has now allowed the possibility of using endovascular techniques to treat this complex anatomy.

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References

  1. Coselli JS, Bozinovski J, LeMaire SA: Open surgical repair of 2286 thoracoabdominal aortic aneurysms, Ann Thorac Surg 83(2):S862–S864, 2007.

    Article  PubMed  Google Scholar 

  2. Svensson LG, Crawford ES, Hess KR, Coselli JS, Safi HJ: Experience with 1509 patients undergoing thoracoabdominal aortic operations, J Vasc Surg 17(2):357–368, 1993.

    Article  PubMed  CAS  Google Scholar 

  3. Conrad MF, Crawford RS, Davison JK, Cambria RP: Thoracoabdominal aneurysm repair: a 20-year perspective, Ann Thorac Surg 83(2):S856–S861, 2007.

    Article  PubMed  Google Scholar 

  4. Cambria RP, Clouse WD, Davison JK, Dunn PF, Corey M, Dorer D: Thoracoabdominal aneurysm repair: results with 337 operations performed over a 15-year interval, Ann Surg 236(4):471–479, 2002.

    Article  PubMed  Google Scholar 

  5. Clouse WD, Marone LK, Davison JK, Dorer DJ, Brewster DC, LaMuraglia GM, Cambria RP: Late aortic and graft-related events after thoracoabdominal aneurysm repair, J Vasc Surg 37(2):254–261, 2003.

    Article  PubMed  Google Scholar 

  6. Crawford RS, Pedraza JD, Chung TK, Corey M, Conrad MF, Cambria RP: Functional outcome after thoracoabdominal aneurysm repair, J Vasc Surg 48(4):828–835, 2008.

    Article  PubMed  Google Scholar 

  7. Crawford ES, DeNatale RW: Thoracoabdominal aortic aneurysm: observations regarding the natural course of the disease, J Vasc Surg 3(4):578–582, 1986.

    Article  PubMed  CAS  Google Scholar 

  8. Lobato AC, Puech-Leao P: Predictive factors for rupture of thoracoabdominal aortic aneurysm, J Vasc Surg 27(3):446–453, 1998.

    Article  PubMed  CAS  Google Scholar 

  9. Juvonen T, Ergin MA, Galla JD, Lansman SL, Nguyen KH, McCullough JN, Levy D, de Asla RA, Bodian CA, Griepp RB: Prospective study of the natural history of thoracic aortic aneurysms, Ann Thorac Surg 63(6):1533–1545, 1997.

    Article  PubMed  CAS  Google Scholar 

  10. Cowan JA Jr, Dimick JB, Henke PK, Huber TS, Stanley JC, Upchurch GR Jr: Surgical treatment of intact thoracoabdominal aortic aneurysms in the US: hospital and surgeon volume-related outcomes, J Vasc Surg 37(6):1169–1174, 2003.

    Article  PubMed  Google Scholar 

  11. Rigberg DA, McGory ML, Zingmond DS, Maggard MA, Agustin M, Lawrence PF, Ko CY: Thirty-day mortality statistics underestimate the risk of repair of thoracoabdominal aortic aneurysms: a statewide experience, J Vasc Surg 43(2):217–222, 2006.

    Article  PubMed  Google Scholar 

  12. Sicard GA, Zwolak RM, Sidawy AN, White RA, Siami FS: Endovascular abdominal aortic aneurysm repair: long-term outcome measures in patients at high-risk for open surgery, J Vasc Surg 44(2):229–236, 2006.

    Article  PubMed  Google Scholar 

  13. Hua HT, Cambria RP, Chuang SK, Stoner MC, Kwolek CJ, Rowell KS, Khuri SF, Henderson WG, Brewster DC, Abbott WM: Early outcomes of endovascular versus open abdominal aortic aneurysm repair in the National Surgical Quality Improvement Program-Private Sector (NSQIP-PS), J Vasc Surg 41(3):382–389, 2005.

    Article  PubMed  Google Scholar 

  14. Stone DH, Brewster DC, Kwolek CJ, Lamuraglia GM, Conrad MF, Chung TK, Cambria RP: Stent-graft versus open-surgical repair of the thoracic aorta: mid-term results, J Vasc Surg 44(6):1188–1197, 2006.

    Article  PubMed  Google Scholar 

  15. Makaroun MS, Dillavou ED, Kee ST, Sicard G, Chaikof E, Bavaria J, Williams D, Cambria RP, Mitchell RS: Endovascular treatment of thoracic aortic aneurysms: results of the phase II multicenter trial of the GORE TAG thoracic endoprosthesis, J Vasc Surg 41(1):1–9, 2005.

    Article  PubMed  Google Scholar 

  16. Roselli EE, Greenberg RK, Pfaff K, Francis C, Svensson LG, Lytle BW: Endovascular treatment of thoracoabdominal aortic aneurysms, J Thorac Cardiovasc Surg 133(6):1474–1482, 2007.

    Article  PubMed  Google Scholar 

  17. Chuter TA, Rapp JH, Hiramoto JS, Schneider DB, Howell B, Reilly LM: Endovascular treatment of thoracoabdominal aortic aneurysms, J Vasc Surg 47(1):6–16, 2008.

    Article  PubMed  Google Scholar 

  18. Quinones-Baldrich WJ, Panetta TF, Vescera CL, Kashyap VS: Repair of type IV thoracoabdominal aneurysm with a combined endovascular and surgical approach, J Vasc Surg 30(3):555–560, 1999.

    Article  PubMed  CAS  Google Scholar 

  19. Flye MW, Choi ET, Sanchez LA, Curci JA, Thompson RW, Rubin BG, Geraghty PJ, Sicard GA: Retrograde visceral vessel revascularization followed by endovascular aneurysm exclusion as an alternative to open surgical repair of thoracoabdominal aortic aneurysm, J Vasc Surg 39(2):454–458, 2004.

    Article  PubMed  Google Scholar 

  20. Zhou W, Reardon M, Peden EK, Lin PH, Lumsden AB: Hybrid approach to complex thoracic aortic aneurysms in high-risk patients: surgical challenges and clinical outcomes, J Vasc Surg 44(4):688–693, 2006.

    Article  PubMed  Google Scholar 

  21. Bockler D, Kotelis D, Geisbusch P, Hyhlik-Durr A, Klemm K, von Tengg-Kobligk H, Kauczor HU, Allenberg JR: Hybrid procedures for thoracoabdominal aortic aneurysms and chronic aortic dissections—a single center experience in 28 patients, J Vasc Surg 47(4):724–732, 2008.

    Article  PubMed  Google Scholar 

  22. Black SA, Wolfe JH, Clark M, Hamady M, Cheshire NJ, Jenkins MP: Complex thoracoabdominal aortic aneurysms: endovascular exclusion with visceral revascularization, J Vasc Surg 43(6):1081–1089, 2006.

    Article  PubMed  Google Scholar 

  23. Chiesa R, Tshomba Y, Melissano G, Marone EM, Bertoglio L, Setacci F, Calliari FM: Hybrid approach to thoracoabdominal aortic aneurysms in patients with prior aortic surgery, J Vasc Surg 45(6):1128–1135, 2007.

    Article  PubMed  Google Scholar 

  24. Patel R, Conrad MF, Paruchuri V, Kwolek CJ, Chung T, Cambria RP: Thoracoabdominal aneurysm repair: hybrid versus open repair, J Vasc Surg 50(1):15–22, 2009.

    Article  PubMed  Google Scholar 

  25. Rutherford RB, Baker JD, Ernst C, Johnston KW, Porter JM, Ahn S, Jones DN: Recommended standards for reports dealing with lower extremity ischemia: revised version, J Vasc Surg 26(3):517–538, 1997.

    Article  PubMed  CAS  Google Scholar 

  26. Chuter TA, Gordon RL, Reilly LM, Kerlan RK, Sawhney R, Jean-Claude J, Canto CJ, LaBerge JM, Ring EJ, Wall SD, Messina LM: Abdominal aortic aneurysm in high-risk patients: short- to intermediate-term results of endovascular repair, Radiology 210(2):361–365, 1999.

    PubMed  CAS  Google Scholar 

  27. Kawaharada N, Morishita K, Fukada J, Hachiro Y, Takahashi K, Abe T: Thoracoabdominal aortic aneurysm repair through redo left-sided thoracotomy, Ann Thorac Surg 77(4):1304–1308, 2004.

    Article  PubMed  Google Scholar 

  28. Greenberg R, Resch T, Nyman U, Lindh M, Brunkwall J, Brunkwall P, Malina M, Koul B, Lindblad B, Ivancev K: Endovascular repair of descending thoracic aortic aneurysms: an early experience with intermediate-term follow-up, J Vasc Surg 31(1 Pt 1):147–156, 2000.

    Article  PubMed  CAS  Google Scholar 

  29. Bavaria JE, Appoo JJ, Makaroun MS, Verter J, Yu ZF, Mitchell RS: Endovascular stent grafting versus open surgical repair of descending thoracic aortic aneurysms in low-risk patients: a multicenter comparative trial, J Thorac Cardiovasc Surg 133(2):369–377, 2007.

    Article  PubMed  Google Scholar 

  30. Matsumura JS, Cambria RP, Dake MD, Moore RD, Svensson LG, Snyder S: International controlled clinical trial of thoracic endovascular aneurysm repair with the Zenith TX2 endovascular graft: 1-year results, J Vasc Surg 47(2):247–257, 2008.

    Article  PubMed  Google Scholar 

  31. Carroccio A, Marin ML, Ellozy S, Hollier LH: Pathophysiology of paraplegia following endovascular thoracic aortic aneurysm repair, J Card Surg 18(4):359–366, 2003.

    Article  PubMed  Google Scholar 

  32. Wolfe JH: Data presented at Houston Aortic Summit. April 2008.

    Google Scholar 

  33. Cambria RP, Brewster DC, L’Italien GJ, Moncure A, Darling RC Jr, Gertler JP, La Muraglia GM, Atamian S, Abbott WM: The durability of different reconstructive techniques for atherosclerotic renal artery disease, J Vasc Surg 20(1):76–85, 1994.

    Article  PubMed  CAS  Google Scholar 

  34. Fulton JJ, Farber MA, Marston WA, Mendes R, Mauro MA, Keagy BA: Endovascular stent-graft repair of pararenal and type IV thoracoabdominal aortic aneurysms with adjunctive visceral reconstruction, J Vasc Surg 41(2):191–198, 2005.

    Article  PubMed  Google Scholar 

  35. Buth J, Harris PL, Hobo R, van Eps R, Cuypers P, Duijm L, Tielbeek X: Neurologic complications associated with endovascular repair of thoracic aortic pathology: incidence and risk factors. a study from the European Collaborators on Stent/Graft Techniques for Aortic Aneurysm Repair (EUROSTAR) registry, J Vasc Surg. 46(6):1103–1110, 2007.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Division of Vascular and Endovascular Surgery, Department of Surgery, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA

    Christopher J. Kwolek MD (Associate Visiting Professor, Program Director) & Rajendra Patel MD (Fellow)

Authors
  1. Christopher J. Kwolek MD
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  2. Rajendra Patel MD
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Correspondence to Christopher J. Kwolek MD .

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Editors and Affiliations

  1. Alpine Road 3270, Portola Valley, 94028, California, USA

    Thomas J. Fogarty

  2. Harbor-UCLA Medical Center, W. Carson St. 1000, Torrance, 90509, California, USA

    Rodney A. White

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Kwolek, C.J., Patel, R. (2010). The Current Status of Hybrid Repair of Thoracoabdominal Aortic Aneurysms. In: Fogarty, T., White, R. (eds) Peripheral Endovascular Interventions. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-1387-6_26

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  • DOI: https://doi.org/10.1007/978-1-4419-1387-6_26

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  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4419-1386-9

  • Online ISBN: 978-1-4419-1387-6

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