초록접수 현황
| 17F-039 | 구연 발표 |
Aortic Remodeling of Stentless-thoracic Endovascular Aortic Repair in Chronic DeBakey IIIb Aneurysm
Tae Hoon Kim¹, Suk-Won Song¹, Woon Heo¹, Won Gi Woo¹, Min-Young Baek¹, Kyung-Jong Yoo², Bum-Koo Cho³
¹Department of Thoracic and Cardiovascular Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea, ²Department of Cardiovascular Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea, ³The Korea Heart Foundation
Purpose : We introduce a new concept of endovascular procedure for favorable aorta remodeling in chronic DeBakey IIIb(CDIIIb) aneurysm and present the early outcome.
Methods : From 2014 to 2017,19 patients underwent stentless-thoracic endovascular aortic repair(TEVAR) for CDIIIb aneurysm.Stentless-TEVAR is defined as an endovascular procedure with closure of communicating channels between true(TL) and false lumen(FL) or obliteration of FL itself using various materials(Figure1).Stent graft within TL of aorta was never deployed in all patients.Complete thrombosis was defined as there was no flow in FL of thoracic aorta.Aortic diameter including TL and FL was measured at 3 levels(left subclavian artery(LSA),pulmonary artery bifurcation(PAB),and celiac axis).
Results : Fifteen of 19 patients (78.9%) demonstrated complete thrombosis. There was no mortality and mean follow up duration was 16.8 months.One patient had transient paraplegia, but completely recovered.Four patients needed reintervention during follow-up, and complete thrombosis was achieved in 3 patients.The FL and TL diameter at LSA and PAB level were significantly changed after procedure(FL:22.6 ± 16.6 Vs. 16.1 ± 14.4 mm, 23.2 ± 14.6 Vs. 18.0 ± 13.2 mm, p= 0.001 and p= 0.001 respectively; TL:22.7 ± 8.7 Vs. 27.9 ± 6.3 mm, 19.0 ± 8.3 Vs. 24.3 ± 6.7 mm, p= 0.001 and p= 0.001, respectively). The number of viabahn stent graft and preoperative FL diameter at PAB were independent risk factors for complete thrombosis (HR[95%CI]: 3.662[1.222-10.978], p=0.020 and 0.900[0.839-0.965], p=0.003, respectively).
Conclusion : Stentless-TEVAR seems to be a safe procedure and shows favorable aorta remodeling. We suggest that this technique can be useful in selected group of patients with CDIIIb aneurysm.
Methods : From 2014 to 2017,19 patients underwent stentless-thoracic endovascular aortic repair(TEVAR) for CDIIIb aneurysm.Stentless-TEVAR is defined as an endovascular procedure with closure of communicating channels between true(TL) and false lumen(FL) or obliteration of FL itself using various materials(Figure1).Stent graft within TL of aorta was never deployed in all patients.Complete thrombosis was defined as there was no flow in FL of thoracic aorta.Aortic diameter including TL and FL was measured at 3 levels(left subclavian artery(LSA),pulmonary artery bifurcation(PAB),and celiac axis).
Results : Fifteen of 19 patients (78.9%) demonstrated complete thrombosis. There was no mortality and mean follow up duration was 16.8 months.One patient had transient paraplegia, but completely recovered.Four patients needed reintervention during follow-up, and complete thrombosis was achieved in 3 patients.The FL and TL diameter at LSA and PAB level were significantly changed after procedure(FL:22.6 ± 16.6 Vs. 16.1 ± 14.4 mm, 23.2 ± 14.6 Vs. 18.0 ± 13.2 mm, p= 0.001 and p= 0.001 respectively; TL:22.7 ± 8.7 Vs. 27.9 ± 6.3 mm, 19.0 ± 8.3 Vs. 24.3 ± 6.7 mm, p= 0.001 and p= 0.001, respectively). The number of viabahn stent graft and preoperative FL diameter at PAB were independent risk factors for complete thrombosis (HR[95%CI]: 3.662[1.222-10.978], p=0.020 and 0.900[0.839-0.965], p=0.003, respectively).
Conclusion : Stentless-TEVAR seems to be a safe procedure and shows favorable aorta remodeling. We suggest that this technique can be useful in selected group of patients with CDIIIb aneurysm.
책임저자: Suk-Won Song
Department of Thoracic and Cardiovascular Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
발표자: Tae Hoon Kim, E-mail : airtech2@naver.com