Hybrid endovascular repair for aortic arch pathology: intermediate outcomes and complications

초록

Background To evaluate the outcomes of hybrid endovascular repair for aortic arch pathology. Methods This study was a retrospective analysis involving patients who underwent hybrid endovascular repair for aortic arch pathologies. Results Twenty-one patients (16 men; mean age, 64.7±16.2 years) with aortic arch pathologies were treated by hybrid endovascular repair. The indications for treatment included increased aneurysm size in 16 cases (71.4%), rupture or impending aneurysmal rupture in 5 cases (23.8%), and rapid growth of aortic dissection (≥ 10mm/y) in 1 case (4.8%). Supra-aortic vessel transposition and stent-graft implantation were achieved in all cases. Two types of stent-graft was used, as follows: the Seal thoracic stent-graft in 14 patients (66.7%); and the Valiant stent grafts in 7 patients (33.3%). Peri-operative complications affected 5 patients (23.8%), as follows: bleeding (n=4, 19.0%); stroke (n=3, 14.3%); renal failure (n=2, 9.5%); vascular injury (n=1, 4.8%), and respiratory failure (n=1, 4.8%). Two patients died within 30 days (9.5%). Technical success was achieved in 15 patients (71.5%). Early endoleaks were noted in 4 patients (19.0%). One patient died during follow-up (mean, 21.3±11.6 months) due to a de novo aortic dissection. Persistent early endoleaks were noted in 4 patients (19.0%); 2 of the 4 patients were successfully managed with implantation of additional stent-grafts. No late onset endoleaks were noted.