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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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    Titre
    • Graft Patency in Long-term Survivors after Renovisceral Debranching with VORTEC
    Auteur
    • Winklehner, Anna. Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland
    • Nguyen-Kim, Thi. Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland
    • Pfammatter, Thomas. Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland
    • Rancic, Zoran. Clinic for Cardiovascular Surgery, University Hospital Zurich, Raemistrasse 100, 8006, Zurich, Switzerland
    • Mayer, Dieter. Clinic for Cardiovascular Surgery, University Hospital Zurich, Raemistrasse 100, 8006, Zurich, Switzerland
    • Lachat, Mario. Clinic for Cardiovascular Surgery, University Hospital Zurich, Raemistrasse 100, 8006, Zurich, Switzerland
    • Frauenfelder, Thomas. Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland
    Type de document
    • Postprint
    Langue
    • Anglais
    Publié dans
    • CardioVascular and Interventional Radiology, 2015, vol. 38, no. 3, p. 606-612. Springer US; http://www.springer-ny.com
    Autre version électronique
    Identifiant OAI-PMH
    • oai:doc.rero.ch:331923
    Summary
    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.