%0 Journal Article
%T Endovascular Repair of Ascending Aortic Pathologies With Tubular Endografts: A Single
%A Christian Detter
%A E. Sebastian Debus
%A Fiona Rohlffs
%A Herrmann Reichenspurner
%A Konstantinos Spanos
%A Nikolaos Tsilimparis
%A Stefan Drewitz
%A Tilo K£¿lbel
%A Yskert von Kodolitsch
%J Journal of Endovascular Therapy
%@ 1545-1550
%D 2019
%R 10.1177/1526602819852083
%X Purpose: To investigate the endovascular treatment of ascending aortic pathologies of high-risk patients unsuitable for open repair. Materials and Methods: From 2010 to 2017, 24 patients (mean age 70¡À15 years, range 29¨C90; 18 men) were treated at a single center for various pathologies of the ascending aorta, including acute or chronic type A aortic dissections (n=16), pseudoaneurysms (n=6), fixation of a dislocated percutaneous aortic valve (n=2), and miscellaneous indications (n=3). The patients were selected following an interdisciplinary case evaluation, attended by cardiologists and cardiac and vascular surgeons. The Zenith Ascend TAA Endovascular Graft was implanted; simultaneous procedures were performed in 13 patients. Of the total 27 Ascend TEVAR procedures (24 primary and 3 reinterventions), 17 were performed urgently and 10 electively. The primary outcome measure was 30-day survival. The secondary outcomes were cardiovascular complications, midterm survival, and reintervention rate. Results: Clinical success was achieved in all but 1 case. The 30-day survival was 79% (19/24); of the 5 deaths only 1 was directly related to the endograft implanted. In the 30-day postoperative period, there was 1 myocardial infarction, 2 major strokes, a mycotic pseudoaneurysm, a case of Ascend TEVAR¨Cinduced high-grade aortic insufficiency, and a minor stroke; 1 patient developed paraplegia after concurrent implantation of a 4-branched abdominal stent-graft. Two patients had a reintervention within 30 days for the pseudoaneurysm and the aortic insufficiency, respectively. During a mean follow-up of 11 months (0¨C35 months), there was 1 late death (cancer) and 1 additional reintervention at 10 months for a late type Ia endoleak (12.5% reintervention rate). Conclusion: Endovascular repair of ascending aortic pathologies with stent-grafts is a feasible treatment option with acceptable early and midterm outcomes in high-risk patients unsuitable for open surgery. The complexity of Ascend TEVAR might justify higher reintervention rates
%K aortic arch
%K arch stent-graft
%K branched stent-graft
%K complications
%K endovascular aneurysm repair
%K mortality
%K paraplegia
%K physician-modified stent-graft
%K reintervention
%K stroke
%K thoracic endovascular aortic repair
%K thoracic stent-graft
%U https://journals.sagepub.com/doi/full/10.1177/1526602819852083