Temporary Perfusion Branches to Decrease Spinal Cord Ischemia in the Endovascular Treatment of Thoraco-Abdominal Aortic Aneurysms: Based on a Presentation at the 2013 VEITH Symposium, November 19-23, 2013 (New York, NY, USA)

Aorta : Official Journal of the Aortic Institute at Yale-New Haven Hospital
Parveen JayiaKrassi Ivancev

Abstract

Spinal cord ischemia (SCI) is one of the most feared complications following the repair of thoraco- abdominal aortic aneurysms (TAAA). Endovascular repair of TAAA is now possible with branched stent grafts, but spinal cord ischaemia rates are still unacceptably high. A number of techniques have been utilized to reduce these levels, however, SCI remains a challenge to endovascular repair of TAAA. The use of sac perfusion branches aims to reduce the incidence of this catastrophic complication. A retrospective analysis of all patients undergoing branched endovascular aortic repair for all thoraco-abdominal aneurysms (TAAA) using custom made devices during January 2008 to August 2014. We describe a two staged technique in which perfusion of segmental vessels is maintained by a temporary endoleak through an open perfusion branch, incorporated within the branched stent graft, followed by a closure of this branch at a later date to complete exclusion of the aneurysm. Forty-seven patients underwent TAAA repair. Twenty-five (53%) had a two-stage procedure using either a sac perfusion branch or a target vessel to perfuse the sac. Nine patients (19.15%) suffered some form of SCI with eight patients having temporary SCI (lasting less than ...Continue Reading

Citations

Oct 4, 2016·Vascular·Marina Dias-NetoSérgio Sampaio
May 27, 2020·Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists·Enrico RinaldiLuca Bertoglio
Aug 28, 2018·Gefässchirurgie : Zeitschrift für vaskuläre und endovaskuläre Chirurgie : Organ der Deutschen und der Österreichischen Gesellschaft für Gefässchirurgie unter Mitarbeit der Schweizerischen Gesellschaft für Gefässchirurgie·F HeidemannT Kölbel

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