Home Current issue Ahead of print Search About us Editorial board Archives Submit article Instructions Subscribe Contacts Login 
ORIGINAL ARTICLE
Year : 2020  |  Volume : 39  |  Issue : 3  |  Page : 668-676

Outcome of hybrid visceral debranching endovascular aortic repair


1 German Aortic Center, Department of Vascular Medicine, University Heart and Vascular Center Hamburg, Hamburg; Department of Vascular and Endovascular Surgery, Faculty of Medicine, Mansoura University, Mansoura, Egypt, Germany
2 German Aortic Center, Department of Vascular Medicine, University Heart and Vascular Center Hamburg, Hamburg, Germany
3 Department of Vascular and Endovascular Surgery, Faculty of Medicine, Mansoura University, Mansoura, Egypt

Correspondence Address:
MD Ahmed Eleshra
German Aortic Center Hamburg, Department of Vascular Medicine, University Heart and Vascular Center Hamburg, Martinistraße 52, 20246 Hamburg
Germany
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ejs.ejs_43_20

Rights and Permissions

Objective The aim was to study the outcomes of hybrid debranching endovascular aortic repair (H-EVAR) for thoracoabdominal aortic aneurysm. Patients and methods Patients who had H-EVAR for treatment of thoracoabdominal aortic aneurysm between January 2010 and December 2018 were included in this study. Early outcome (30 days) in terms of mortality, morbidity, and target vessel patency were analyzed. Follow-up outcomes in terms of late death, endoleak, and re-intervention rates were evaluated. Results A total of 33 patients (48% males) with a mean age of 68±13 years were included. Eighteen (55%) patients were asymptomatic, whereas eight (24%) patients were symptomatic and seven (21%) patients had a contained rupture. Six (18%) patients died after the visceral debranching operation (stage 1), and 27 (82%) patients completed both stages of H-EVAR. The 30-day mortality in completed H-EVAR was 5 (19%) of 27 patients. Five (15%) patients developed spinal cord ischemia. Four (12%) patients had post-operative dialysis. Two (6%) patients had a stroke. Four (12%) patients experienced respiratory failure. Four (12%) patients had mesenteric ischemia and two (6%) had ischemic colitis. The 30-day overall primary target vessel patency rate was 92±3%. Early endoleak I rate was 3 (11%) of 27 patients, and endoleak III rate was 2 (7%) of 27 patients (completed H-EVAR). The mean follow-up period was 23±11 months for 22 patients who survived the completed H-EVAR. Late death occurred in 4 (18%) of 22 patients. Conclusion Hybrid EVAR had several advantages that included avoiding thoracotomy, aortic cross-clamping, single-lung ventilation, and the need for extensive dissection in multiple aortic segments. However, the controversial outcomes led to criticism, and there is a need to examine the three techniques (open, hybrid, and total endovascular) simultaneously, which would give a unique definition of the selection criteria to achieve the optimum results in each patient.


[FULL TEXT] [PDF]*
Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed199    
    Printed4    
    Emailed0    
    PDF Downloaded21    
    Comments [Add]    

Recommend this journal