Result of a multicenter study on the Physician-Modified Fenestrated and Branched Endovascular Grafts for thoracoabdominal aneurysms.

IF 3.6 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Annals of Thoracic Surgery Pub Date : 2025-02-11 DOI:10.1016/j.athoracsur.2025.01.025

Guangmin Yang, Yepeng Zhang, Haiya Ni, Leiyang Zhang, Ping Wang, Xiaoqiang Li, Ming Zhang, Min Zhou

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引用次数: 0

Abstract

Background: Physician modified fenestrated and branched endografts (PMEGs) have emerged as an endovascular solution for managing thoraco-abdominal aortic aneurysms (TAAAs) in the past decade. This study aimed to evaluate the outcomes and experience of three high- volume centers.

Methods: Patients' data from three academic center in China, spanning from 2017 and 2021, were retrospectively collected and analyzed. Early outcomes were assessed through peri-operative morbidity and mortality. Follow-up outcomes included survival, freedom from reintervention, and target vessels patency.

Results: A total of 186 patients (156 males; mean age 68.4 ± 13.4 years) with TAAAs underwent PMEG procedures. A total of 618 target vessels were incorporated via fenestrations or branches. Postoperative all-cause was 6.5%, with aneurysm-related deaths accounting for 1.6%. Morbidity included acute kidney injury (5.9%), stroke (1.1%), myocardial infarction (2.7%), and limb ischemia, respiratory failure, and bowel ischemia requiring resection (each 1.6%). One patient developed transient spinal cord injury. With a mean follow-up of 3.4±1.3 years, 1-and 3-year survival rates were 96% and 94%, respectively. The 1-and 3-year secondary patency rates of target vessels were 99% and 98%, while freedom from reintervention rate were 95% and 91%.

Conclusions: Fenestrated and branched endovascular aneurysm repair with PMEGs appears to be a safe and effective treatment for complex aortic aneurysms. While early and mid-term outcomes are promising and comparable to those of custom-made devices, further follow-up is essential to confirm long-term efficacy.

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来源期刊

Annals of Thoracic Surgery 医学-呼吸系统

CiteScore

6.40

自引率

13.00%

发文量

1235

审稿时长

42 days

期刊介绍： The mission of The Annals of Thoracic Surgery is to promote scholarship in cardiothoracic surgery patient care, clinical practice, research, education, and policy. As the official journal of two of the largest American associations in its specialty, this leading monthly enjoys outstanding editorial leadership and maintains rigorous selection standards. The Annals of Thoracic Surgery features: • Full-length original articles on clinical advances, current surgical methods, and controversial topics and techniques • New Technology articles • Case reports • "How-to-do-it" features • Reviews of current literature • Supplements on symposia • Commentary pieces and correspondence • CME • Online-only case reports, "how-to-do-its", and images in cardiothoracic surgery. An authoritative, clinically oriented, comprehensive resource, The Annals of Thoracic Surgery is committed to providing a place for all thoracic surgeons to relate experiences which will help improve patient care.