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- W1978782833 abstract "ObjectiveHybrid repair of thoracoabdominal aortic aneurysms (TAAA) may reduce morbidity and mortality in high-risk candidates for open repair. This study reviews the outcomes of hybrid TAAA repair for Crawford extent I-III TAAA in high-risk patients in comparison to patients who underwent concurrent open TAAA repair.MethodsDuring the interval from June 2005 to December 2007, a total of 23 high-risk patients with TAAA (type I: 9 [39%], II: 5 [22%], and III: 9 [39%]) underwent renal and/or mesenteric debranching (11 [48%] with four vessel debranching) with subsequent placement of a thoracic stent graft; 77 patients underwent open TAAA repair (type I: 13 [17%], II: 11 [14%], III: 27 [35%], and IV: 26 [34%]) during the same interval. The primary high-risk criteria for hybrid TAAA included advanced age/poor functional status (n = 14), major pulmonary dysfunction (n = 8), and technical consideration (prior thoracic aortic aneurysm repair [n = 4] or prior thoracoabdominal aneurysm repair [n = 2] and obesity [n = 2]) with 6 patients having overlapping high-risk criteria. Composite (30-day) mortality and/or permanent paraplegia (PP) were the major study endpoints.ResultsThe hybrid and open TAAA groups had (respectively) no statistical difference in mean age (76.6 vs 72.7 years), aneurysm size (6.51 vs 6.52 cm), and non-elective operation (30.4% vs 26.0%). The hybrid group had a higher mean Society for Vascular Surgery (SVS) risk score (9.1 vs 6.0; P ≤ .001), incidence of oxygen-dependent chronic obstructive pulmonary disease (COPD) (34.8% vs 2.6%; P ≤ .001), and prior thoracic (n = 4) or thoracoabdominal (n = 2) repair (26.1% vs 1.3%; P ≤ .001). Composite mortality and/or PP was doubled in the hybrid group (21.7% vs 11.7%; P = .33). The rate of any type of reoperation was higher in hybrid TAAA repair (39.1% vs 20.8%; P = .03). One year actuarial survival for both groups was comparable (hybrid, 68 ± 12%; open, 73 ± 6%). A total of 5/23 (22%) hybrid TAAA patients developed an endoleak (type I: 3/23 and type II: 2/23) with 3 requiring endovascular re-intervention. A total of 7/70 (10%) visceral/renal bypass grafts were noted to be occluded during follow-up (1 superior mesenteric artery, 1 celiac, and 5 renal). Examination of patients with an SVS risk score ≤8 (mean SVS risk score in hybrid 6.2 [n = 10] vs 5.5 [n = 68] in open; P = .27) revealed the hybrid group had a higher incidence of composite mortality and/or PP (40% vs 10.3%; P = .03).ConclusionHybrid TAAA repair in high-risk patients has significant morbidity and mortality suggesting a non-interventional approach may be appropriate in many such patients. The morbidity and mortality of the hybrid TAAA repair was substantial even in lower risk patients (SVS risk score ≤8), albeit patient numbers were small. Prospective study in comparable patient risk cohorts is required to define the role of hybrid TAAA repair. Hybrid repair of thoracoabdominal aortic aneurysms (TAAA) may reduce morbidity and mortality in high-risk candidates for open repair. This study reviews the outcomes of hybrid TAAA repair for Crawford extent I-III TAAA in high-risk patients in comparison to patients who underwent concurrent open TAAA repair. During the interval from June 2005 to December 2007, a total of 23 high-risk patients with TAAA (type I: 9 [39%], II: 5 [22%], and III: 9 [39%]) underwent renal and/or mesenteric debranching (11 [48%] with four vessel debranching) with subsequent placement of a thoracic stent graft; 77 patients underwent open TAAA repair (type I: 13 [17%], II: 11 [14%], III: 27 [35%], and IV: 26 [34%]) during the same interval. The primary high-risk criteria for hybrid TAAA included advanced age/poor functional status (n = 14), major pulmonary dysfunction (n = 8), and technical consideration (prior thoracic aortic aneurysm repair [n = 4] or prior thoracoabdominal aneurysm repair [n = 2] and obesity [n = 2]) with 6 patients having overlapping high-risk criteria. Composite (30-day) mortality and/or permanent paraplegia (PP) were the major study endpoints. The hybrid and open TAAA groups had (respectively) no statistical difference in mean age (76.6 vs 72.7 years), aneurysm size (6.51 vs 6.52 cm), and non-elective operation (30.4% vs 26.0%). The hybrid group had a higher mean Society for Vascular Surgery (SVS) risk score (9.1 vs 6.0; P ≤ .001), incidence of oxygen-dependent chronic obstructive pulmonary disease (COPD) (34.8% vs 2.6%; P ≤ .001), and prior thoracic (n = 4) or thoracoabdominal (n = 2) repair (26.1% vs 1.3%; P ≤ .001). Composite mortality and/or PP was doubled in the hybrid group (21.7% vs 11.7%; P = .33). The rate of any type of reoperation was higher in hybrid TAAA repair (39.1% vs 20.8%; P = .03). One year actuarial survival for both groups was comparable (hybrid, 68 ± 12%; open, 73 ± 6%). A total of 5/23 (22%) hybrid TAAA patients developed an endoleak (type I: 3/23 and type II: 2/23) with 3 requiring endovascular re-intervention. A total of 7/70 (10%) visceral/renal bypass grafts were noted to be occluded during follow-up (1 superior mesenteric artery, 1 celiac, and 5 renal). Examination of patients with an SVS risk score ≤8 (mean SVS risk score in hybrid 6.2 [n = 10] vs 5.5 [n = 68] in open; P = .27) revealed the hybrid group had a higher incidence of composite mortality and/or PP (40% vs 10.3%; P = .03). Hybrid TAAA repair in high-risk patients has significant morbidity and mortality suggesting a non-interventional approach may be appropriate in many such patients. The morbidity and mortality of the hybrid TAAA repair was substantial even in lower risk patients (SVS risk score ≤8), albeit patient numbers were small. Prospective study in comparable patient risk cohorts is required to define the role of hybrid TAAA repair." @default.
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- W1978782833 date "2009-07-01" @default.
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- W1978782833 title "Thoracoabdominal aneurysm repair: Hybrid versus open repair" @default.
- W1978782833 cites W1965696191 @default.
- W1978782833 cites W1966920806 @default.
- W1978782833 cites W1967994349 @default.
- W1978782833 cites W1969317124 @default.
- W1978782833 cites W1972051055 @default.
- W1978782833 cites W1975521684 @default.
- W1978782833 cites W1988276918 @default.
- W1978782833 cites W2006413145 @default.
- W1978782833 cites W2006508476 @default.
- W1978782833 cites W2012892901 @default.
- W1978782833 cites W2015544299 @default.
- W1978782833 cites W2017240512 @default.
- W1978782833 cites W2028795507 @default.
- W1978782833 cites W2029419155 @default.
- W1978782833 cites W2036040016 @default.
- W1978782833 cites W2043517681 @default.
- W1978782833 cites W2055885839 @default.
- W1978782833 cites W2059267586 @default.
- W1978782833 cites W2068106325 @default.
- W1978782833 cites W2070078805 @default.
- W1978782833 cites W2083805145 @default.
- W1978782833 cites W2085905760 @default.
- W1978782833 cites W2087234202 @default.
- W1978782833 cites W2087926073 @default.
- W1978782833 cites W2106275314 @default.
- W1978782833 cites W2106373946 @default.
- W1978782833 cites W2113018640 @default.
- W1978782833 cites W2120138923 @default.
- W1978782833 cites W2145031794 @default.
- W1978782833 cites W2160641151 @default.
- W1978782833 cites W2161407834 @default.
- W1978782833 cites W2162315471 @default.
- W1978782833 cites W4249253802 @default.
- W1978782833 doi "https://doi.org/10.1016/j.jvs.2008.12.051" @default.
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