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Conference Paper: Retrograde type A dissection following hybrid supra-aortic endovascular surgery in high risk patients unfit for conventional open repair

TitleRetrograde type A dissection following hybrid supra-aortic endovascular surgery in high risk patients unfit for conventional open repair
Authors
Issue Date2014
PublisherJ-STAGE.
Citation
The 15th Congress of Asian Society for Vascular Surgery (ASVS 2014) and 9th Asian Venous Forum, Hong Kong, 5-7 September 2014. In Annals of Vascular Diseases, 2014, v. 7 suppl., p. S34, abstract no. 0148 How to Cite?
AbstractINTRODUCTION: Hybrid procedures with combined open extra-anatomical supra-aortic bypasses and endovascular surgery are less invasive for patients with complex aortic arch pathology. The aim of this paper is to report patients who developed retrograde Type A aortic dissection following initially successful hybrid endovascular treatment. METHODS: Retrospective review of prospectively collected computerized departmental database. All patients with supra-aortic hybrid endovascular surgery and post-procedure retrograde Type A dissection were identified. Patient demographics, comorbid conditions, perioperative parameters, procedural details and post-operative complications were collected. RESULTS: From May 2005 to March 2014, 163 patients underwent thoracic aortic endovascular procedures at our institution, of which 46 of them had supra-aortic hybrid endovascular repair. Six patients (6/163 (3.6% of all thoracic stentgrafts cases); 6/46 (13% of all supra-aortic hybrid cases), 3 males) developed retrograde Type A aortic dissection. All were elective cases, with 3 chronic dissecting aneurysms and 3 atherosclerotic aneurysms. All had one stage hybrid procedures: 2 patients had carotid-carotid bypass grafts, 1 had carotid-carotid-left subclavian bypass graft, and 3 had bypass grafts from ascending aorta to innominate artery and left carotid artery. Five patients had Cook Zenith thoracic stentgrafts (CookR, Bloomington, USA), and 1 had MedtronicR Valiant stentgrafts (Medtronic Vascular Inc, Santa Rosa, USA). The retrograde Type A dissection occurred with sudden symptoms at day 5, 6, 10, 20, 105 and 128 respectively. There were 3 immediate fatalities and 2 patients treated conservatively deemed unfit for reintervention (one died at 9 month of pneumonia, and one remained alive at 7 months post-complication). One patient underwent successful emergency open surgery and survived. CONCLUSION: Supra-aortic hybrid procedures in treating aortic arch pathology are not protective of retrograde Type A dissection, and patients with this post-operative complication inevitably have poor outcome, even with early diagnosis or treatment is delayed.
DescriptionFree paper presentation - Thoracic Aorta Disease 1: FP6C: 0148
This journal entitled: Abstract Book of the 15th Congress of Asian Society for Vascular Surgery and 9th Asian Venous Forum 2014
Persistent Identifierhttp://hdl.handle.net/10722/206063
ISSN

 

DC FieldValueLanguage
dc.contributor.authorYip, HCen_US
dc.contributor.authorChan, YCen_US
dc.contributor.authorTing, ACWen_US
dc.contributor.authorCheng, SWKen_US
dc.date.accessioned2014-10-20T12:00:23Z-
dc.date.available2014-10-20T12:00:23Z-
dc.date.issued2014en_US
dc.identifier.citationThe 15th Congress of Asian Society for Vascular Surgery (ASVS 2014) and 9th Asian Venous Forum, Hong Kong, 5-7 September 2014. In Annals of Vascular Diseases, 2014, v. 7 suppl., p. S34, abstract no. 0148en_US
dc.identifier.issn1881-641X-
dc.identifier.urihttp://hdl.handle.net/10722/206063-
dc.descriptionFree paper presentation - Thoracic Aorta Disease 1: FP6C: 0148-
dc.descriptionThis journal entitled: Abstract Book of the 15th Congress of Asian Society for Vascular Surgery and 9th Asian Venous Forum 2014-
dc.description.abstractINTRODUCTION: Hybrid procedures with combined open extra-anatomical supra-aortic bypasses and endovascular surgery are less invasive for patients with complex aortic arch pathology. The aim of this paper is to report patients who developed retrograde Type A aortic dissection following initially successful hybrid endovascular treatment. METHODS: Retrospective review of prospectively collected computerized departmental database. All patients with supra-aortic hybrid endovascular surgery and post-procedure retrograde Type A dissection were identified. Patient demographics, comorbid conditions, perioperative parameters, procedural details and post-operative complications were collected. RESULTS: From May 2005 to March 2014, 163 patients underwent thoracic aortic endovascular procedures at our institution, of which 46 of them had supra-aortic hybrid endovascular repair. Six patients (6/163 (3.6% of all thoracic stentgrafts cases); 6/46 (13% of all supra-aortic hybrid cases), 3 males) developed retrograde Type A aortic dissection. All were elective cases, with 3 chronic dissecting aneurysms and 3 atherosclerotic aneurysms. All had one stage hybrid procedures: 2 patients had carotid-carotid bypass grafts, 1 had carotid-carotid-left subclavian bypass graft, and 3 had bypass grafts from ascending aorta to innominate artery and left carotid artery. Five patients had Cook Zenith thoracic stentgrafts (CookR, Bloomington, USA), and 1 had MedtronicR Valiant stentgrafts (Medtronic Vascular Inc, Santa Rosa, USA). The retrograde Type A dissection occurred with sudden symptoms at day 5, 6, 10, 20, 105 and 128 respectively. There were 3 immediate fatalities and 2 patients treated conservatively deemed unfit for reintervention (one died at 9 month of pneumonia, and one remained alive at 7 months post-complication). One patient underwent successful emergency open surgery and survived. CONCLUSION: Supra-aortic hybrid procedures in treating aortic arch pathology are not protective of retrograde Type A dissection, and patients with this post-operative complication inevitably have poor outcome, even with early diagnosis or treatment is delayed.-
dc.languageengen_US
dc.publisherJ-STAGE.-
dc.relation.ispartofAnnals of Vascular Diseasesen_US
dc.titleRetrograde type A dissection following hybrid supra-aortic endovascular surgery in high risk patients unfit for conventional open repairen_US
dc.typeConference_Paperen_US
dc.identifier.emailChan, YC: ycchan88@hku.hken_US
dc.identifier.emailTing, ACW: tingacw@hku.hken_US
dc.identifier.emailCheng, SWK: wkcheng@hku.hken_US
dc.identifier.authorityChan, YC=rp00530en_US
dc.identifier.authorityCheng, SWK=rp00374en_US
dc.description.naturelink_to_OA_fulltext-
dc.identifier.doi10.3400/avd.sup.14-00001-
dc.identifier.hkuros241408en_US
dc.identifier.volume7en_US
dc.identifier.issuesuppl.-
dc.identifier.spageS34en_US
dc.identifier.epageS34en_US
dc.publisher.placeJapan-

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