Rebecca Kolet, Marco Virgilio Usai, Yousef Shehada, Bärbel Berekhoven, Veronika Weyer-Elberich, Martin Austermann
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引用次数: 0
Abstract
Objective: Previous studies showed that branched endovascular aneurysm repair (BEVAR) carries a significant risk for adverse renal events. The purpose of this study was to evaluate the performance of the balloon expandable covered stent graft (BECS) Advanta/iCast V12, the Viabahn balloon expandable (VBX), and the BECS Advanta combined with a distal deployed self expanding covered stent (SECS) Viabahn (VSX) as bridging stent grafts (BSGs) in renal arteries.
Methods: A retrospective analysis of prospectively collected data was conducted at a single centre. Patients undergoing BEVAR who had at least one Advanta, Advanta + VSX, or VBX as BSG in renal arteries were included. Endpoints were patency, endoleaks, target vessel instability (TVI), re-interventions, as well as clinical outcomes including kidney function, new dialysis needs, and death. Data were analysed using Kaplan-Meier estimations and multivariable Cox regression.
Results: The study included 255 patients with 431 BSGs in renal arteries treated for complex aortic repair between 2010 and 2019. Advanta was predominantly used in 2010 - 2014, Advanta + VSX in 2015 - 2017, and VBX in 2018 - 2019. Overall, 125 Advanta, 146 Advanta + VSX, and 160 VBX were implanted. Median follow up time was 19.3 months. At three years, estimated primary patencies were 82.7 ± 4.6% for renal arteries treated with Advanta, 96.8 ± 1.8% for Advanta + VSX, and 89.0 ± 3.2% for VBX. Estimated freedom from TVI at three years was 82.4 ± 4.7% for renal arteries treated with Advanta, 94.1 ± 2.4% for Advanta + VSX, and 85.4 ± 3.5% for VBX. Freedom from re-intervention estimations at three years were 86.3 ± 3.4% in the Advanta cohort, 95.1 ± 2.0% in the Advanta + VSX cohort, and 91.6 ± 2.4% in the VBX cohort.
Conclusion: The combination of BECS and SECS seems to be superior in terms of primary patency compared with BECS alone.
期刊介绍：
The European Journal of Vascular and Endovascular Surgery is aimed primarily at vascular surgeons dealing with patients with arterial, venous and lymphatic diseases. Contributions are included on the diagnosis, investigation and management of these vascular disorders. Papers that consider the technical aspects of vascular surgery are encouraged, and the journal includes invited state-of-the-art articles.
Reflecting the increasing importance of endovascular techniques in the management of vascular diseases and the value of closer collaboration between the vascular surgeon and the vascular radiologist, the journal has now extended its scope to encompass the growing number of contributions from this exciting field. Articles describing endovascular method and their critical evaluation are included, as well as reports on the emerging technology associated with this field.
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