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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
Title | Retrograde type A dissection following hybrid supra-aortic endovascular surgery in high risk patients unfit for conventional open repair |
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Authors | |
Issue Date | 2014 |
Publisher | J-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? |
Abstract | INTRODUCTION: 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. |
Description | Free 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 Identifier | http://hdl.handle.net/10722/206063 |
ISSN | 2023 Impact Factor: 0.6 |
DC Field | Value | Language |
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dc.contributor.author | Yip, HC | en_US |
dc.contributor.author | Chan, YC | en_US |
dc.contributor.author | Ting, ACW | en_US |
dc.contributor.author | Cheng, SWK | en_US |
dc.date.accessioned | 2014-10-20T12:00:23Z | - |
dc.date.available | 2014-10-20T12:00:23Z | - |
dc.date.issued | 2014 | en_US |
dc.identifier.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 | en_US |
dc.identifier.issn | 1881-641X | - |
dc.identifier.uri | http://hdl.handle.net/10722/206063 | - |
dc.description | Free paper presentation - Thoracic Aorta Disease 1: FP6C: 0148 | - |
dc.description | This journal entitled: Abstract Book of the 15th Congress of Asian Society for Vascular Surgery and 9th Asian Venous Forum 2014 | - |
dc.description.abstract | INTRODUCTION: 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.language | eng | en_US |
dc.publisher | J-STAGE. | - |
dc.relation.ispartof | Annals of Vascular Diseases | en_US |
dc.title | Retrograde type A dissection following hybrid supra-aortic endovascular surgery in high risk patients unfit for conventional open repair | en_US |
dc.type | Conference_Paper | en_US |
dc.identifier.email | Chan, YC: ycchan88@hku.hk | en_US |
dc.identifier.email | Ting, ACW: tingacw@hku.hk | en_US |
dc.identifier.email | Cheng, SWK: wkcheng@hku.hk | en_US |
dc.identifier.authority | Chan, YC=rp00530 | en_US |
dc.identifier.authority | Cheng, SWK=rp00374 | en_US |
dc.description.nature | link_to_OA_fulltext | - |
dc.identifier.doi | 10.3400/avd.sup.14-00001 | - |
dc.identifier.hkuros | 241408 | en_US |
dc.identifier.volume | 7 | en_US |
dc.identifier.issue | suppl. | - |
dc.identifier.spage | S34 | en_US |
dc.identifier.epage | S34 | en_US |
dc.publisher.place | Japan | - |
dc.identifier.issnl | 1881-641X | - |