The influence of narrow aortic bifurcation on limb graft patency: a two-center retrospective study.

IF 1.4 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Journal of Cardiovascular Surgery Pub Date : 2022-12-01 Epub Date: 2022-08-01 DOI:10.23736/S0021-9509.22.12007-0

Wen Wen, Hozan Mufty, Athanasios Katsargyris, Geert Maleux, Kim Daenens, Sabrina Houthoofd, Inge Fourneau, Eric Verhoeven

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Abstract

Background: Narrow aortic bifurcation (NAB) has been considered as a potential risk factor for graft limb thrombosis after endovascular aortic repair (EVAR). The aim of this study was to compare mid- and long-term outcome of EVAR in patients with NAB and standard aortic bifurcation (SAB).

Methods: Data from patients receiving EVAR were prospectively collected and retrospectively analyzed. In case of angiographic limb stenosis (>50%), additional stenting was performed. Patients with a NAB (≤20mm) were included in the NAB group, the remaining patients in the SAB group. Primary endpoints were limb thrombosis rate and technical success.

Results: A total of 902 patients were included; 18.3% (N.=165/902) in the NAB and 81.7% (N.=737/902) in the SAB group. Mean follow-up time was 43 months (range 0-198 months). Bilateral stenting of the aortic bifurcation was performed in 2.7% (N.=27/902), 8.5% (N.=14/165) in the NAB and 1.4% (N.=10/737) in the SAB group (P=0.001). Limb thrombosis was found in 2.8% (N.=25/902), 3.6% (N.=6/165) in the NAB and 2.6% (N.=19/737) in the SAB group (P=0.55). Technical success was 97.8%, 98.8% in the NAB and 97.6% in the SAB group (P=0.33). Device related reintervention rate was 16% (N.=144/902), 15.2% in the NAB and 16.1% in the SAB group (P=0.75).

Conclusions: Standard EVAR could safely be performed in patients with NAB (≤20mm) when a low threshold for additional stenting was applied. This resulted in no significant higher incidence of limb thrombosis. Additional stent deployment did not increase the complication rate.

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主动脉分叉狭窄对肢体移植物通畅的影响:一项双中心回顾性研究。

背景:狭窄的主动脉分叉(NAB)被认为是血管内主动脉修复(EVAR)后移植物肢体血栓形成的潜在危险因素。本研究的目的是比较NAB和标准主动脉分叉(SAB)患者EVAR的中期和长期结果。方法:前瞻性收集EVAR患者资料并进行回顾性分析。如果血管造影下肢狭窄(>50%)，则进行额外支架置入。NAB(≤20mm)患者为NAB组，其余患者为SAB组。主要终点是肢体血栓率和技术成功率。结果:共纳入902例患者;NAB组为18.3% (n =165/902)， SAB组为81.7% (n =737/902)。平均随访时间43个月(0 ~ 198个月)。NAB组为2.7% (n =27/902)， NAB组为8.5% (n =14/165)， SAB组为1.4% (n =10/737) (P=0.001)。NAB组肢体血栓发生率分别为2.8% (n =25/902)、3.6% (n =6/165)和2.6% (n =19/737) (P=0.55)。技术成功率97.8%，NAB组为98.8%，SAB组为97.6% (P=0.33)。器械相关再干预率为16% (n =144/902)， NAB组为15.2%，SAB组为16.1% (P=0.75)。结论:对于NAB(≤20mm)患者，在低阈值的情况下，可以安全地进行标准EVAR。这导致肢体血栓的发生率没有明显增加。额外的支架部署没有增加并发症的发生率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Cardiovascular Surgery 医学-外科

CiteScore

2.50

自引率

7.10%

发文量

204

审稿时长

4-8 weeks

期刊介绍： The Journal of Cardiovascular Surgery publishes scientific papers on cardiac, thoracic and vascular surgery. Manuscripts may be submitted in the form of editorials, original articles, review articles, case reports, therapeutical notes, special articles and letters to the Editor. Manuscripts are expected to comply with the instructions to authors which conform to the Uniform Requirements for Manuscripts Submitted to Biomedical Editors by the International Committee of Medical Journal Editors (www.icmje.org). Articles not conforming to international standards will not be considered for acceptance.