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Italian Journal of Vascular and Endovascular Surgery 2019 March;26(1):10-3

DOI: 10.23736/S1824-4777.18.01387-6

Copyright © 2018 EDIZIONI MINERVA MEDICA

lingua: Inglese

The impact of new technologies in endovascular repair of thoraco-abdominal aortic aneurysm

Enrico GALLITTO, Rodolfo PINI , Chiara MASCOLI, Mortalla DIENG, Mohammad ABUALHIN, Stefano ANCETTI, Gianluca FAGGIOLI, Andrea STELLA, Mauro GARGIULO

Department of Vascular Surgery, University of Bologna “Alma Mater Studiorum”, Policlinico S. Orsola-Malpighi, Bologna, Italy



BACKGROUND: Thoraco-abdominal aortic aneurysms (TAAAs) are considered a challenging clinical scenarios. Despite modern intra/peri-operative adjuncts, TAAA open repair has not negligible mortality and morbidity rates also in high volume centres. New technologies with the endovascular approach can reduce the complication rate of TAAA treatment. Aim of present work is to evaluate the outcome of endovascular treatment of TAAA in a single centre.
METHODS: A retrospective evaluation of the endovascular TAAA treatment in a single center from 2010 to 2017 was performed. The technical success, mortality, morbidity and visceral vessels patency were evaluated at 30-day and during the follow-up.
RESULTS: In the study period, an overall of 80 TAAAs (urgent and elective cases) were treated in our centre by FB-EVAR. Five cases were ruptured TAAAs (6.3%). Custom made and off the shelf device were used in 57 (71.2%) and 23 (28.8%) cases for an overall of 289 target visceral vessels (3.6/patient). Technical Success was 92.5%. The postoperative target visceral vessels patency rate was 97.0%. Spinal cord ischemia was 6%. The 30-day mortality was 3.8%. At a mean follow-up was 18.5- SD 15.0 months the overall survival was 96%, 83%, and 70% at 6, 12 and 24 months.
CONCLUSIONS: The total endovascular TAAA repair is technical demanding, time-consuming, and requires a dedicated and advanced knowledge in the endovascular materials, technologies and a dedicated team for planning. However the results are promising and associated with low mortality and morbidity.


KEY WORDS: Aortic aneurysm, thoracic - Endovascular procedures - Technology

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