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Techniques for aortic arch endovascular repair.

Hongku, Kiattisak; Dias, Nuno LU ; Sonesson, Björn LU and Resch, Tim LU (2016) In Journal of Cardiovascular Surgery 57(3). p.421-436
Abstract
This article reviews endovascular strategies for aortic arch repair. Open repair remains the gold standard particularly for good risk patients. Endovascular treatment potentially offers a less invasive repair. Principles, technical considerations, devices and outcomes of each technique are discussed and summarized. Hybrid repair combines less invasive revascularization options, instead of arch replacement while extending stent graft into the arch. Outcomes vary with regard to extent of repair and aortic arch pathologies treated. Results of arch chimney and other parallel graft techniques perhaps make it a less preferable choice for elective cases. However, they are very appealing options for urgent or bailout situations. Fenestrated stent... (More)
This article reviews endovascular strategies for aortic arch repair. Open repair remains the gold standard particularly for good risk patients. Endovascular treatment potentially offers a less invasive repair. Principles, technical considerations, devices and outcomes of each technique are discussed and summarized. Hybrid repair combines less invasive revascularization options, instead of arch replacement while extending stent graft into the arch. Outcomes vary with regard to extent of repair and aortic arch pathologies treated. Results of arch chimney and other parallel graft techniques perhaps make it a less preferable choice for elective cases. However, they are very appealing options for urgent or bailout situations. Fenestrated stent grafting is subjected to many technical challenges in aortic arch due to difficulties in stent graft orientation and fenestration positioning. In situ fenestration techniques emerge to avoid these problems, but durability of stent grafts after fenestration and ischemic consequences of temporary carotid arteries coverage raises some concern total arch repair using this technique. Arch branched graft is a new technology. Early outcomes did not meet the expectation; however the results have been improving after its learning curve period. Refining stent graft technologies and implantation techniques positively impact outcomes of endovascular approaches. (Less)
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author
organization
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type
Contribution to journal
publication status
published
subject
in
Journal of Cardiovascular Surgery
volume
57
issue
3
pages
421 - 436
publisher
Edizioni Minerva Medica
external identifiers
  • pmid:26940011
  • scopus:84984814957
ISSN
0021-9509
language
English
LU publication?
yes
id
fcf376f2-4830-4589-a02d-881923836658 (old id 8856339)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/26940011?dopt=Abstract
date added to LUP
2016-03-15 13:05:12
date last changed
2017-07-09 04:35:47
@article{fcf376f2-4830-4589-a02d-881923836658,
  abstract     = {This article reviews endovascular strategies for aortic arch repair. Open repair remains the gold standard particularly for good risk patients. Endovascular treatment potentially offers a less invasive repair. Principles, technical considerations, devices and outcomes of each technique are discussed and summarized. Hybrid repair combines less invasive revascularization options, instead of arch replacement while extending stent graft into the arch. Outcomes vary with regard to extent of repair and aortic arch pathologies treated. Results of arch chimney and other parallel graft techniques perhaps make it a less preferable choice for elective cases. However, they are very appealing options for urgent or bailout situations. Fenestrated stent grafting is subjected to many technical challenges in aortic arch due to difficulties in stent graft orientation and fenestration positioning. In situ fenestration techniques emerge to avoid these problems, but durability of stent grafts after fenestration and ischemic consequences of temporary carotid arteries coverage raises some concern total arch repair using this technique. Arch branched graft is a new technology. Early outcomes did not meet the expectation; however the results have been improving after its learning curve period. Refining stent graft technologies and implantation techniques positively impact outcomes of endovascular approaches.},
  author       = {Hongku, Kiattisak and Dias, Nuno and Sonesson, Björn and Resch, Tim},
  issn         = {0021-9509},
  language     = {eng},
  month        = {03},
  number       = {3},
  pages        = {421--436},
  publisher    = {Edizioni Minerva Medica},
  series       = {Journal of Cardiovascular Surgery},
  title        = {Techniques for aortic arch endovascular repair.},
  volume       = {57},
  year         = {2016},
}