초록접수 현황
| 14F-185 | 구연 발표 |
The Role of Open Surgical Repair in the Treatment of Degenerative Aortic Arch Aneurysm in the Endovascular Era
Sung Jun Lee¹, Jae Suk Yoo¹, Sun Kyun Ro², Joon Bum Kim¹, Sung-Ho Jung¹, Cheol Hyun Chung¹, Jae Won Lee¹, Suk Jung Choo¹
Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine¹
Department of Throacic and Cardiovascular Surgery, Hanyang University Guri Hospital, Hanyang University College of Medicine²
Background : Hybrid endovascular procedures are perceived as less invasive and therefore safer alternative methods to the open surgical technique. The aim of this study was to compare the outcomes endovascular and conventional surgical methods for treating degenerative aortic arch aneurysm.
Methods : From January 2000 to December 2013, a total of 65 patients were surgically treated for degenerative aortic arch aneurysm and grouped according to the treatment modality; Open surgical repair (OSR, group I, n=45) and Hybrid endovascular procedure ( TEVAR, group II, n=25). Propensity score adjusted matching of the two groups resulted in two groups of 22 patients each i.e., OSRp, n=22 and TEVARp, n=22. Early and late outcomes were compared.
Results : Direct comparison of the overall clinical outcomes showed no significant inter-group differences in the incidence of early major morbidities, early/hospital deaths and overall mortality rate during the follow up duration. Unadjusted and adjusted Hazard ratio showed no significant benefit of TEVAR over OSR (HR 0.59, p=0.32) as well as a stronger tendency for higher retreatment risk in the TEVAR group vs OSR group (HR 0.15, p=0.006)
Conclusion : The results of the current data showed no significant difference in terms of the risk of adverse primary endpoints of death and retreatment between the two groups. Considering the shorter follow up and the insignificant but adverse hazard ratio of the TEVAR group, the data supports a OSR for young and relatively low risk surgery patients.
Methods : From January 2000 to December 2013, a total of 65 patients were surgically treated for degenerative aortic arch aneurysm and grouped according to the treatment modality; Open surgical repair (OSR, group I, n=45) and Hybrid endovascular procedure ( TEVAR, group II, n=25). Propensity score adjusted matching of the two groups resulted in two groups of 22 patients each i.e., OSRp, n=22 and TEVARp, n=22. Early and late outcomes were compared.
Results : Direct comparison of the overall clinical outcomes showed no significant inter-group differences in the incidence of early major morbidities, early/hospital deaths and overall mortality rate during the follow up duration. Unadjusted and adjusted Hazard ratio showed no significant benefit of TEVAR over OSR (HR 0.59, p=0.32) as well as a stronger tendency for higher retreatment risk in the TEVAR group vs OSR group (HR 0.15, p=0.006)
Conclusion : The results of the current data showed no significant difference in terms of the risk of adverse primary endpoints of death and retreatment between the two groups. Considering the shorter follow up and the insignificant but adverse hazard ratio of the TEVAR group, the data supports a OSR for young and relatively low risk surgery patients.
책임저자: 주석중
Department of thoracic and cardiovascular surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul
연락처 : 이성준, Tel: 02-3010-3580 , E-mail : medics97@naver.com
