Portal de investigação
Multicenter Study on Physician-Modified Endografts for Thoracoabdominal and Complex Abdominal Aortic Aneurysm Repair
Autores da FMUP
Participantes de fora da FMUP
- Tsilimparis, N
- Melo, R
- Tenorio, ER
- Scali, S
- Mendes, B
- Han, SK
- Schermerhorn, M
- Adam, DJ
- Malas, MB
- Farber, M
- Kölbel, T
- Starnes, B
- Joseph, G
- Branzan, D
- Cochennec, F
- Timaran, C
- Bertoglio, L
- Cieri, E
- Pedro, LM
- Verzini, F
- Beck, AW
- Chait, J
- Pyun, A
- Magee, GA
- Swerdlow, N
- Juszczak, M
- Barleben, A
- Patel, R
- Gomes, VC
- Panuccio, G
- Sweet, MP
- Zettervall, SL
- Becquemin, JP
- Canonge, J
- Porras-Colón, J
- Giordano, A
- Oderich, GS
Unidades de investigação
Abstract
BACKGROUND:Physician modified endografts (PMEGs) have been widely used in the treatment of complex abdominal aortic aneurysm and thoracoabdominal aortic aneurysm, however, previous data are limited to small single center studies and robust data on safety and effectiveness of PMEGs are lacking. We aimed to perform an international multicenter study analyzing the outcomes of PMEGs in complex abdominal aortic aneurysms and thoracoabdominal aortic aneurysms.METHODS:An international multicenter single-arm cohort study was performed analyzing the outcomes of PMEGs in the treatment of elective, symptomatic, and ruptured complex abdominal aortic aneurysms and thoracoabdominal aortic aneurysms. Variables and outcomes were defined according to the Society for Vascular Surgery reporting standards. Device modification and procedure details were collected and analyzed. Efficacy outcomes included technical success and safety outcomes included major adverse events and 30-day mortality. Follow-up outcomes included reinterventions, endoleaks, target vessel patency rates and overall and aortic-related mortality. Multivariable analysis was performed aiming at identifying predictors of technical success, 30-day mortality, and major adverse events.RESULTS:Overall, 1274 patients were included in the study from 19 centers. Median age was 74 (IQR, 68-79), and 75.7% were men; 45.7% were complex abdominal aortic aneurysms, and 54.3% were thoracoabdominal aortic aneurysms; 65.5% patients presented electively, 24.6% were symptomatic, and 9.9% were ruptured. Most patients (83.1%) were submitted to a fenestrated repair, 3.6% to branched repair, and 13.4% to a combined fenestrated and branched repair. Most patients (85.8%) had >= 3 target vessels included. The overall technical success was 94% (94% in elective, 93.4% in symptomatic, and 95.1% in ruptured cases). Thirty-day mortality was 5.8% (4.1% in elective, 7.6% in symptomatic, and 12.7% in ruptured aneurysms). Major adverse events occurred in 25.2% of cases (23.1% in elective, 27.8% in symptomatic, and 30.3% in ruptured aneurysms). Median follow-up was 21 months (5.6-50.6). Freedom from reintervention was 73.8%, 61.8%, and 51.4% at 1, 3, and 5 years; primary target vessel patency was 96.9%, 93.6%, and 90.3%. Overall survival and freedom from aortic-related mortality was 82.4%/92.9%, 69.9%/91.6%, and 55.0%/89.1% at 1, 3, and 5 years.CONCLUSIONS:PMEGs were a safe and effective treatment option for elective, symptomatic, and ruptured complex aortic aneurysms. Long-term data and future prospective studies are needed for more robust and detailed analysis.
Dados da publicação
- ISSN/ISSNe:
- 0009-7322, 1524-4539
- Tipo:
- Article
- Páginas:
- 1327-1342
- Link para outro recurso:
- www.scopus.com
Circulation Lippincott Williams and Wilkins Ltd.
Citações Recebidas na Web of Science: 2
Citações Recebidas na Scopus: 7
Documentos
- Não há documentos
Filiações
Keywords
- endovascular aneurysm repair; fenestrated endovascular aneurysm repair; FEVAR; multicenter study; physician modified endograft; PMEG; surgeon-modified endograft
Campos de estudo
Proyectos asociados
A study on using radiomic analysis to examine hostile neck anatomy in abdominal aortic aneurysms
Investigador Principal: Marina Felicidade Dias Neto
Estudo Clínico Académico (Aortic Aneurysms) . 2023
Red blood cell distribution width predicts myocardial infarction and mortality after vascular surgery - A prospective cohort study
Investigador Principal: Marina Felicidade Dias Neto
Estudo Clínico Académico (Red blood) . 2021
Secondary intervention and surveillance after abdominal aortic aneurysm repair: retrospective cohort study
Investigador Principal: Marina Felicidade Dias Neto
Estudo Clínico Académico (Aortic aneurysm) . 2022
High-dependency unit care after carotid endarterectomy for asymptomatic stenosis
Investigador Principal: Marina Felicidade Dias Neto
Estudo Clínico Académico . 2020
Recurrence of Varicose Veins After Surgery
Investigador Principal: Marina Felicidade Dias Neto
Estudo Clínico Académico . 2022
Radiomics Signature of Abdominal Aortic Aneurysm Neck: A Cross-Sectional Study
Investigador Principal: Marina Felicidade Dias Neto
Estudo Clínico Académico . 2022
ABO-blood groups and outcomes after abdominal aortic aneurysm repair
Investigador Principal: Marina Felicidade Dias Neto
Estudo Clínico Académico . 2022
Citar a publicação
Tsilimparis N,Melo R,Tenorio ER,Scali S,Mendes B,Han SK,Schermerhorn M,Adam DJ,Malas MB,Farber M,Kölbel T,Starnes B,Joseph G,Branzan D,Cochennec F,Timaran C,Bertoglio L,Cieri E,Pedro LM,Verzini F,Beck AW,Chait J,Pyun A,Magee GA,Swerdlow N,Juszczak M,Barleben A,Patel R,Gomes VC,Panuccio G,Sweet MP,Zettervall SL,Becquemin JP,Canonge J,Porras J,Dias M,Giordano A,Oderich GS. Multicenter Study on Physician-Modified Endografts for Thoracoabdominal and Complex Abdominal Aortic Aneurysm Repair. Circulation. 2024. 150. (17):p. 1327-1342. IF:37,800. (1).
