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Early outcomes associated with use of the Zenith TX2 Dissection Endovascular Graft for the treatment of Stanford type B aortic dissection.

Authors
  • Patel, Jayna J1
  • Kasprzak, Piotr2
  • Pfister, Karin2
  • Tsilimparis, Nikolaos3
  • Kölbel, Tilo3
  • Wahlgren, Carl4
  • Hammo, Sari4
  • Mani, Kevin5
  • Wanhainen, Anders5
  • Rossi, Giovanni6
  • Leo, Enrico6
  • Böing, Ingeborg7
  • Schelzig, Hubert8
  • Oberhuber, Alexander9
  • Aasgaard, Frode10
  • Vecchiati, Enrico11
  • Fontana, Antonio11
  • Modarai, Bijan12
  • 1 Academic Department of Vascular Surgery, School of Cardiovascular Medicine and Sciences, BHF Centre of Excellence and the Biomedical Research Centre at Guy's & St Thomas' NHS Foundation Trust and King's College London, London, UK.
  • 2 University Hospital Regensburg, Department of Vascular Surgery, Regensburg, Germany. , (Germany)
  • 3 German Aortic Center Hamburg, Vascular Medicine, University Heart & Vascular Center Hamburg, Hamburg, Germany. , (Germany)
  • 4 Department of Vascular Surgery, Karolinska University Hospital, and Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden. , (Sweden)
  • 5 Department of Surgical Sciences, Vascular Surgery, Uppsala University, Uppsala, Sweden. , (Sweden)
  • 6 Division of Vascular Surgery, Department of Cardiovascular Diseases, A. Manzoni Hospital, Lecco, Italy. , (Italy)
  • 7 Department of Surgery, Aarhus University Hospital, Aarhus, Denmark. , (Denmark)
  • 8 Department of Vascular and Endovasccular Surgery, University Hospital Düsseldorf, Düsseldorf, Germany. , (Germany)
  • 9 Department of Vascular and Endovascular Surgery, University Hospital Münster, Münster, Germany. , (Germany)
  • 10 Department of Vascular Surgery, St Olavs Hospital, Trondheim, Norway. , (Norway)
  • 11 Department of Vascular Surgery, Hospital Santa Maria of Reggio Emilla, Reggio Emilla, Italy. , (Italy)
  • 12 Academic Department of Vascular Surgery, School of Cardiovascular Medicine and Sciences, BHF Centre of Excellence and the Biomedical Research Centre at Guy's & St Thomas' NHS Foundation Trust and King's College London, London, UK. Electronic address: [email protected]
Type
Published Article
Journal
Journal of vascular surgery
Publication Date
Aug 01, 2021
Volume
74
Issue
2
Pages
547–555
Identifiers
DOI: 10.1016/j.jvs.2021.01.048
PMID: 33600932
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

To evaluate short term outcomes related to the use of the Zenith TX2 Dissection Endovascular Graft (ZDEG) and the Zenith Dissection Bare stent (ZDES) for the treatment of Stanford type B aortic dissections. This retrospective multicenter case cohort study collated data from 10 European institutions for patients with both complicated and uncomplicated type B aortic dissection treated with ZDEG and ZDES between 2011 and 2018. The primary end point was mortality at 30 and 90 days. Secondary end points included complications related to TEVAR, such as, type Ia endoleak, stroke, paraparesis, paraplegia, and retrograde type A dissection (RTAD). Statistical analysis was carried out using the t test, or one-way analysis of variance and the χ2 or Fisher exact tests. We treated 120 patients (87 male; mean age, 62.7 ± 12.2years) either in the acute 76 (63.3%), subacute 16 (13.3%), or chronic 28 (23.3%) phase. Seven patients (5.8%) died within 30 days after the index procedure and two (1.7%) between 30 and 90 days. There was one instance of postoperative RTAD in a patient treated for rupture. Stroke and paraplegia occurred in three (2.5%) and five (4.2%), patients, respectively. Eight patients (6.7%) had a type Ia endoleak in the perioperative period. There were no instances of paraplegia, no permanent dialysis, and no requirement for adjunctive superior mesenteric or celiac artery stenting in the 33 patients (27.5%) who were treated by concurrent placement of ZDES distal to the ZDEG. The length and distal oversizing of ZDEG components used was less in this group. The present series demonstrates a low (<1%) RTAD rate and favorable morbidity and mortality. The lower rate of paraplegia, dialysis, and visceral artery stenting in the cohort that had adjunctive use of ZDES is compelling and merits further assessment. Copyright © 2021 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

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