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- Document type:
- Article
- Author(s):
- Wolf, O; Bockler, D; Heider, P; Klemm, K; Schumacher, H; Hanke, M; Kotelis, D; Allenberg, JR; Eckstein, HH
- Title:
- Hybrid procedure for treatment of thoracoabdominal aortic aneurysms (TAAA). Initial experience in a high-risk population
- Abstract:
- Introduction. Open replacement of the aorta for treatment of thoracoabdominal aortic aneurysms (TAAA) is liable to complications. The combination therapy consisting in endovascular bypass of the TAAA and proximal/distal diversion of supraaortal vessels and of the visceral and renal arteries (debranching) could be a technical alternative for the high-risk patient. Patients and methods. We report on a consecutive prospective series of 47 patients with TAAA (29.8% female; median age 65.5 years, range 37-81 years; 44 in ASA stage > 3). In 51% of cases the aneurysm was an arteriosclerotic TAAA, while in 38.3% a secondarily expanding type B aortic dissection was present and in 10.6%, a plaque rupture or a Carrel patch stretched by an aneurysm. Results. The 30-day mortality was 12.6% (6/47 patients) for the whole series and 7.4% 3/41) for those with nonruptured TAAA. The corresponding paraparesis/paraplegia rates were 4.2% and 8.5%. In 8.5% renal insufficiency requiring dialysis arose in the postoperative period. The mean length of stay in hospital was 21.3-26 (11-68)days and the mean length of stay in the intensive care unit, 9 (2- 31)days. Conclusions. The hybrid operation is a technically and logistically challenging alternative to conventional thoracoabdominal aortic replacement for the high risk patient. To optimise the result, the procedure must be evaluated prospectively against the conventional standard treatment.
- Journal title abbreviation:
- GEFASSCHIRURGIE
- Year:
- 2007
- Journal volume:
- 12
- Journal issue:
- 5
- Pages contribution:
- 338-+
- Language:
- de
- Print-ISSN:
- 0948-7034
- TUM Institution:
- Fachgebiet Gefäßchirurgie (Prof. Eckstein)
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