초록접수 현황
| 20F-065 | 구연 발표 |
Zone 2 TEVAR: Is it still a good option for all types of thoracic aortic disease?
Bongyeon Sohn, Joon Chul Jung, Hyoung Woo Chang, Jae Hang Lee, Dong Jung Kim, Jun Sung Kim, Cheong Lim, and Kay-Hyun Park
Department of Thoracic and Cardiovascular Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Gyeonggi-do, Republic of Korea
Purpose : Zone 2 thoracic endovascular aortic repair (TEVAR) for the thoracic aortic disease involving left subclavian artery remains controversial. We aimed to study the clinical outcomes of zone 2 TEVAR depending on the types of thoracic aortic disease.
Methods : 48 patients who underwent zone 2 TEVAR between December, 2010 and July, 2020 were enrolled. The indications were aortic aneurysm (n=15), acute aortic dissection (AAD, n=14), penetrating aortic ulcer (PAU, n=8), traumatic aortic injury (TAI, n=8), and others (n=3). The clinical outcomes including postoperative radiologic findings were retrospectively reviewed.
Results : Technical success rate was 100% and in-hospital mortality occurred in 1 patient. The early postoperative complications included stroke (n=1), transient spinal cord ischemia (n=1), neck wound hematoma (n=1), and left phrenic or vagus nerve injury (n=9). In patients with AAD, positive remodeling was found in 10 patients (71.4%); false lumen regression in the entire or thoracic aorta (n=9), false lumen thrombosis in the thoracic aorta (n=1). However, in patients with aortic aneurysm, the increased size of the aorta was found in 6 patients (40%). Among them, definite endoleak was not found in 3 patients. The persistent aneurysmal growing was found in patients (4 of 8, 50%) with maximal aortic diameter larger than 60 mm on initial imaging.
Conclusion : Zone 2 TEVAR might be an effective option of treatment for AAD, PAU, TAI. However, it would be desirable to consider open surgical repair rather than TEVAR, in case of large aortic aneurysm.
Methods : 48 patients who underwent zone 2 TEVAR between December, 2010 and July, 2020 were enrolled. The indications were aortic aneurysm (n=15), acute aortic dissection (AAD, n=14), penetrating aortic ulcer (PAU, n=8), traumatic aortic injury (TAI, n=8), and others (n=3). The clinical outcomes including postoperative radiologic findings were retrospectively reviewed.
Results : Technical success rate was 100% and in-hospital mortality occurred in 1 patient. The early postoperative complications included stroke (n=1), transient spinal cord ischemia (n=1), neck wound hematoma (n=1), and left phrenic or vagus nerve injury (n=9). In patients with AAD, positive remodeling was found in 10 patients (71.4%); false lumen regression in the entire or thoracic aorta (n=9), false lumen thrombosis in the thoracic aorta (n=1). However, in patients with aortic aneurysm, the increased size of the aorta was found in 6 patients (40%). Among them, definite endoleak was not found in 3 patients. The persistent aneurysmal growing was found in patients (4 of 8, 50%) with maximal aortic diameter larger than 60 mm on initial imaging.
Conclusion : Zone 2 TEVAR might be an effective option of treatment for AAD, PAU, TAI. However, it would be desirable to consider open surgical repair rather than TEVAR, in case of large aortic aneurysm.
책임저자: Jae Hang Lee
Department of Thoracic and Cardiovascular Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Gyeonggi-do, Republic of Korea
발표자: Bongyeon Sohn, E-mail : s.bongyeon@gmail.com