Early Limb Reperfusion Using Routinely Preloaded Fenestrated Stent-graft Designs for Complex Endovascular Aortic Procedures.

Cardiovascular and Interventional Radiology
Luca BertoglioRoberto Chiesa

Abstract

To evaluate the outcomes of the preloaded stent-graft design (PLD) in the routine treatment of pararenal and thoraco-abdominal aneurysms compared to the standard design (SND). Patients treated by fenestrated/branched endovascular aneurysm repair from 2013 were collected. Since 2017, PLD (23F delivery system) was implemented in our standard practice and the outcomes are reported. Primary outcome measurements were: technical success, 30-day adverse events, leg ischemia time, procedural time and radiation exposure. Secondary outcome measurements were: intraoperative urinary output, need of bicarbonate supplementation, postoperative biomarkers elevations and need for blood transfusions. A propensity 1:1 matching for graft design and aneurysm extent was performed with the SND (18F delivery system) cohort to highlight possible PLD advantages. A PLD was employed in 32 non-consecutive patients with a technical and clinical success rate of 100% and 81% respectively: no mortality was recorded. The Society for Vascular Surgery grade ≥ 1 adverse event was observed in 10 cases (31%): five temporary paraparesis were observed. Seventeen PLD patients were matched. The procedural time was shorter in PLD group (266 vs. 390 min; p = 0.001) as wel...Continue Reading

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Citations

Sep 21, 2020·Annals of Vascular Surgery·Gioele SimonteMassimo Lenti

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