Graft Patency in Long-term Survivors after Renovisceral Debranching with VORTEC
Winklehner, Anna ; Nguyen-Kim, Thi ; Pfammatter, Thomas ; Rancic, Zoran ; Mayer, Dieter ; Lachat, Mario ; Frauenfelder, Thomas
In: CardioVascular and Interventional Radiology, 2015, vol. 38, no. 3, p. 606-612
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- Purpose: This study was designed to evaluate retrospectively the long-term stent-graft patency after renovisceral revascularization with Viabahn Open Revascularization Technique (VORTEC) using computed tomography angiography (CTA) and magnetic resonance angiography (MRA). Methods: In 34 patients (seven women; mean age 72±8years) with aortic aneurysm, 63 renovisceral vessels (i.e., 54 renal, nine visceral arteries) were revascularized with VORTEC between 2004 and 2009. All patients obtained a pre- and postinterventional CTA and at least one follow-up CTA or MRA after 6 or more months following intervention (median follow up: 43months). Detection of bypass occlusion, bypass stenosis, infolding, stent-graft fractures and dislocations, and kidney shrinkage were noted by two readers in consensus. Furthermore, mortality during follow-up was assessed using the medical report. Results: During follow-up, 12.6% of stent-grafts occluded. Cumulative patency rate was 95.2±2.7% at 12months, 87.7±4.4% at 24 and 36months, and 84.7±5.2% at 48, 60, 72, 84, and 89months, respectively. Overall, 19% of stent-grafts (12/63) developed bypass stenosis (<50%, 10 stent-grafts;>50%, 2 stent-grafts), in one case stenosis (>70%) was suspected to be hemodynamically significant. No secondary dislocation, no infolding of renovisceral stent-grafts, and no stent-graft fracture occurred. Kidney shrinkage occurred in nine patients, primarily in patients with an occluded Viabahn (n=7). Eleven patients (32.3%) died within the follow-up time period. Conclusions: In long-term survivors after VORTEC cumulative patency rate remained high, and no stent-graft fractures or secondary dislocations occurred.