The Risks of Celiac Artery Coverage During Endoluminal Repair of Thoracic and Thoracoabdominal Aortic Aneurysms

Vascular and Endovascular Surgery - Tập 43 Số 1 - Trang 51-60 - 2009
Luis R. Léon1, Joseph L. Mills2, William D. Jordan3, Mark Morasch4, Margaret Kovacs5, Gary J. Becker1, Bülent Arslan6
1Southern Arizona Veterans Affairs Health Care System (SAVAHCS), Tucson, Arizona, , University of Arizona Health Science Center (AHSC), Tucson, Arizona
2University of Arizona Health Science Center (AHSC), Tucson, Arizona, Southern Arizona Veterans Affairs Health Care System (SAVAHCS), Tucson, Arizona
3University of Alabama at Birmingham
4North-western University Medical Center, Chicago, Illinois
5Baptist Cardiac & Vascular Institute of Miami, Miami, Florida
6University of Virginia Health System, Charlottesville, Virginia

Tóm tắt

The risks of purposeful celiac artery coverage during endovascular thoracic aortic aneurysm repair (TEVAR) to obtain an adequate distal landing zone have received scant scientific attention. Patients undergoing TEVAR at 6 tertiary centers from January 2000 to June 2007 were identified (n = 434); cases requiring celiac artery exclusion (n = 19; 4.4% of the total) were analyzed. The mean follow-up was 8.7 months (range, 0.2-21.2). The mean patients' age was 73.6 years (range, 56-86); 57.9% were men. The mean aneurysm diameter was 6.7 cm (range, 5-8.6). In 2 patients, the celiac artery balloon occlusion test was performed prior to TEVAR. In both, intact collateral foregut circulation was seen. Both underwent TEVAR without celiac artery revascularization; 1 did well, whereas the other developed foregut ischemia. In 16 cases (84.2%), the celiac artery was not revascularized prior to TEVAR. In those patients, 19 complications were reported (3 deaths; 2 paraplegia). No similar events occurred in those who underwent celiac artery revascularization (n = 3). Celiac artery coverage during TEVAR is required in 4.4% of cases. TEVAR correlated with a nonnegligible number of major complications. Complications were more frequent and severe in patients who did not have celiac artery revascularization prior to TEVAR. Specific celiac artery coverage complications are rare and not readily predictable based on preprocedure arteriography.

Từ khóa


Tài liệu tham khảo

10.1016/j.ejvs.2006.12.032

10.1016/j.jvs.2006.12.062

10.1016/j.jvs.2006.11.040

10.1016/j.ejvs.2006.06.016

10.1583/06-1903.1

10.1016/j.jvs.2006.02.056

10.1016/j.jvs.2005.05.063

10.1016/j.surg.2005.06.043

10.1258/rsmvasc.13.4.236

10.1177/152660280200900618

10.1177/152660280100800103

10.1177/152660280000700613

10.1016/S0022-5223(99)70096-6

10.1016/S0022-5223(97)70096-5

10.1583/1545-1550(2002)009<0180:TCAEAA>2.0.CO;2

10.1016/j.jvs.2005.11.049

10.1007/S10016-006-9027-x

10.1016/S0039-6109(05)70549-1

Kadir S., 1991, Atlas of Normal and Variant Angiographic Anatomy

Pintilie DG, 2003, Rev Med Chir Soc Med Nat Iasi, 107, 826

10.1080/00365520510012091

10.1007/s10016-004-0143-1

10.1016/j.gassur.2004.11.004

10.1016/j.jvs.2005.01.043

10.1177/000331970005100710

Thapar PM, 2000, Indian J Gastroenterol, 19, 139

10.1016/j.ejvs.2007.05.023

10.1016/j.jvs.2005.12.071

10.1583/03-1145.1

Tachibana K., 2005, Ann Thorac Cardiovasc Surg, 11, 335

Kotsis T., 2003, Int Angiol, 22, 125

10.1007/s11748-005-0083-x

10.1583/05-1743MR.1

10.1177/152660280000700304

Thông tin
Thông tin xuất bản

Vascular and Endovascular Surgery

Tập 43 Số 1

51-60

Thông tin tác giả