J Ebdovasc Ther: Results of a multicenter study of CH-EVAR in the treatment of asymptomatic dPAA patients

In recent years, the chimney technique endovascular abdominal aortic aneurysm repair (CH-EVAR) has rapidly developed its role in the treatment of complex AAA and other pararenal aortic aneurysm (dPAA) lesions
.

CH-EVAR has subsequently received much attention and has been included in the latest SVS and ESVS guidelines

Research purposes

Research purposes

To evaluate the efficacy of elective CH-EVAR in the treatment of asymptomatic dPAA patients
.

Research methods

Research methods

From 2008 to 2014, we analyzed patients who underwent elective CH-EVAR surgery at medical centers in 13 European and American countries
.

A total of 517 patients underwent CH-EVAR surgery, including 326 patients with dPAA; after excluding patients with symptoms and/or rupture, 275 patients with asymptomatic dPAA remained; another 8 patients were lost to follow-up, and 267 patients with dPAA were finally included in the study Retrospective analysis

Research result

Research result

The average age of the 267 patients was 75.
2±7.
4 years, the proportion of males was 82.
0%, and 442 visceral blood vessels were involved
.

During the operation, 6 renal arteries were covered by aortic grafts, and the remaining 436 blood vessels were reconstructed

Primary endpoint results: The 30-day mortality rate after surgery was 1.
9% (n=5), and the rate of in-hospital complications was 10.
1% (n=27), including 3 cases of stroke, 1 case of permanent dialysis, and 1 case of intestinal ischemia
.

Type Ia endoleak is detected within 30 days

Table 1.
Details of complications and deaths

Table 1.
Details of complications and deaths Table 1.
Details of complications and deaths

Figure 1.
Kaplan-Meier survival curve

Figure 1.
Kaplan-Meier survival curve Figure 1.
Kaplan-Meier survival curve

Secondary endpoint results: 7 visceral vessels were occluded during the operation, of which only 1 was CH-EVAR-related CG occlusion
.

Within 30 days, 7 CGs of 6 patients were obstructed (Table 2)

Table 2.
Main results within 30 days after operation

Table 2.
Main results within 30 days after operation Table 2.
Main results within 30 days after operation

Figure 2.
Kaplan-Meier curve of patency rates in the first and second phases

Figure 2.
Kaplan-Meier curves of the patency rates in the first and second phases Figure 2.
Kaplan-Meier curves of the patency rates in the first and second phases

Summarize

Summarize

For the treatment of dPAA, elective CH-EVAR surgery is long-lasting and effective
.

The results of this study are comparable to the results of other published intracavitary treatments, which also proves that CH-EVAR has certain application prospects in the treatment of asymptomatic dPAA patients

Original source:

Original source:

Pitoulias G, Fazzini S, Donas K, et al.

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