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Thorac Cardiovasc Surg 2025; 73(01): 019-024
DOI: 10.1055/a-2132-4571
Original Cardiovascular

Combined Endovascular Treatment of Complex Aortic Pathologies

Levent Mavioglu
1   Department of Cardiovascular Surgery, Ankara City Hospital, Cankaya, Turkey
,
Hakki Zafer Iscan
1   Department of Cardiovascular Surgery, Ankara City Hospital, Cankaya, Turkey
,
Goktan Askin
1   Department of Cardiovascular Surgery, Ankara City Hospital, Cankaya, Turkey
,
Serkan Mola
1   Department of Cardiovascular Surgery, Ankara City Hospital, Cankaya, Turkey
,
Naim Boran Tumer
1   Department of Cardiovascular Surgery, Ankara City Hospital, Cankaya, Turkey
,
Ertekin Utku Unal
2   Department of Cardiovascular Surgery, Ufuk University, Ankara, Ankara, Turkey
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Abstract

Aim Multisegmented aortic pathologies present challenging issues independent of the treatment chosen. Whether open or endovascular, staged, or simultaneous, every treatment modality has its own pros and cons. We revealed our patients retrospectively with early and midterm results who had simultaneous endovascular thoracic and abdominal aortic repair for thoracic aortic pathologies and infrarenal abdominal aortic aneurysm (iAAA) as a single-center experience.

Materials and Methods Between January 2016 and January 2021, 16 patients were diagnosed with thoracic aortic pathology and iAAA was simultaneously repaired in an endovascular manner. All patients were operated on with the same cardiovascular surgeon team.

Results The average age of the patients were 76.9 ± 6.2 (64–86) years. There was no early mortality. The technical success was 100%. In total, 18 thoracic endografts were deployed in 16 patients for thoracic aortic pathologies. Follow-up period was 21.85 ± 8.96 months, and in the follow-up period, two patients had a secondary intervention. One cardiac and one coronavirus disease 2019 mortality was detected in the follow-up period. There was no aneurysm-related mortality. The postoperative first-year survival was 84.6 ± 10.0.

Conclusion Simultaneous endovascular solution for complex multisegmented aortic pathologies provides a rapid, less-invasive approach with successful early and midterm morbidity, mortality with short intensive care unit period, and length of hospital stay. A combination of endovascular aortic aneurysm repair and thoracic endovascular aortic repair where anatomic suitability exists is a strong alternative over staged and hybrid therapies. Contrast-induced nephropathy, postimplantation syndrome, and spinal cord ischemia should be carefully monitored with this strategy.

Keywords

endovascular procedures - thoracic aortic aneurysm - aortic - aneurysm


Publication History

Received: 07 March 2023

Accepted: 17 July 2023

Accepted Manuscript online:
18 July 2023

Article published online:
11 August 2023

© 2023. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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