Outcomes of Endovascular Management
of Aortic Arch Lesion
Attapoom Susupaus MD*, Wittawat Pibul MD*,
Rakphun Swasdipanich MD*, Saksan Jitvisate MD**
Affiliation :
* Department of Cardiovascular and Thoracic Surgery, Rajavithi Hospital, College of Medicine,
Rangsit University, Bangkok, Thailand
** Department of Radiology, Rajavithi Hospital, College of Medicine, Rangsit University, Bangkok, Thailand
Objective : Assess the outcomes of treating aortic diseases involving the transverse aortic arch with a hybrid approach in
high-risk patients.
Material and Method: Between March 2008 and January 2010, 29 thoracic stent grafts were implanted in 15 patients with
aortic arch disease (mean age, 66.99.34 years) for aortic arch repair of eight degenerative aneurysms, two complicated
aortic dissections, and five penetrating atheromatous ulcer or pseudoaneurysm. Debranching was performed to provide an
adequate proximal aortic landing zone, in five patients by a cervical approach and in four patients by a sternotomy approach.
Results : The technical success rates for aortic zone 0 patients (n = 4), zone 1 patients (n = 3), and zone 2 patients (n = 8)
were 100%. The 30-day mortality rate was 6.7%. The actuarial survival was 80% over a mean follow-up of 11.7 months.
The rate of stroke was 6.7%. There was type II endoleak in one patient.
Conclusion : The use of a hybrid endovascular and open surgical approach for the treatment of arch diseases is safe and
effective at early follow-up, including the potential to offer therapy to patients who are not candidates for open repair.
Keywords : Thoracic aorta, Aortic arch, Aortic dissection, Endovascular repair, Stent graft
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