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Raimund Erbel - One of the best experts on this subject based on the ideXlab platform.
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thoracic aortic aneurysm expansion due to late distal Stent Graft induced new entry
Catheterization and Cardiovascular Interventions, 2015Co-Authors: Rolf Alexander Janosi, Holger Eggebrecht, Heinz Jakob, Konstantinos Tsagakis, Markus Bettin, Philipp Kahlert, Michael Horacek, Fadi Alrashid, Thomas Schlosser, Raimund ErbelAbstract:Objectives: This study analyzed the mechanism and risk factors of thoracic aortic aneurysm expansion due to late distal Stent Graft-induced new entry (dSINE). Background: This late complication of thoracic endovascular aneurysm repair (TEVAR) for aortic dissection is under-recognized but potentially life-threatening. Methods: In 142 patients who underwent TEVAR with endovascular entry sealing for acute and chronic aortic type B dissection, using commercially available straight (nontapered) StentGrafts, we examined the oversizing rate, the aortic taper ratio, and the need for reintervention. Results: Nine of 142 patients developed thoracic aortic aneurysm expansion due to dSINE after TEVAR. The median follow-up was 47.5637.4 months. There was a significant difference in the distal Stent‐aorta angle between the patients with and without dSINE (149.08615.09 ! vs. 166.72612.47 ! , P<0.005). Patients with dSINE showed a significantly higher taper ratio of the true lumen of the aorta (40.9614.13% vs. 25.36620.2%, P<0.05). There was also a significant difference in the oversizing of the Stent-Graft in the distal landing zone (95.88649.3% vs. 55.94636.23%, P<0.01). All patients with dSINE underwent a secondary endoGraft procedure without any complications or deaths. In 7 cases we used a custom-made, highly tapered Stent-Graft. Conclusions: Lifelong follow-up of patients is mandatory after TEVAR. A Stent-Graft with a tapered design should be used in aortic dissection to avoid oversizing and devastating late complications. V C 2014 Wiley Periodicals, Inc.
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endovascular Stent Graft placement in aortic dissection a meta analysis
European Heart Journal, 2006Co-Authors: Holger Eggebrecht, Christoph A. Nienaber, Tim C. Rehders, Heinz Jakob, Markus Neuhauser, Dietrich Baumgart, Stephan Kische, Axel Schmermund, Ulf Herold, Raimund ErbelAbstract:Aims This article summarizes all available published data with respect to clinical success, complications, and outcomes of endovascular Stent–Graft placement among patients with descending aortic dissection (AD). Methods and results We performed a meta-analysis of all published series on retrograde endovascular Stent–Graft placement encompassing � 3 patients with AD. Thirty-nine studies, involving a total of 609 patients, were included. Procedural success was reported in 98.2+ 0.5% of patients. Major complications were reported in 11.1+ 1.4%, with the most dreaded neurologic complications in 2.9 + 0.7% patients. Periprocedural stroke was encountered more frequently than paraplegia (1.9+ 0.6% vs. 0.8+ 0.4%). Overall complications were significantly higher in patients undergoing Stent–Graft placement for acute AD than in patients with chronic AD (21.7 + 2.8% vs. 9.1+ 2.3%, P ¼ 0.005). The overall 30-day mortality was 5.3+ 0.9%, and was three-fold higher in patients with acute AD when compared with chronic AD (9.8 + 2.2% vs. 3.2+ 1.4%, P ¼ 0.015). In addition, 2.8 + 0.7% of patients died over a mean follow-up period of 19.5 + 7.1 months. Kaplan–Meier analysis yielded overall survival rates of 90.6+ 1.6% at 6 months, 89.9+ 1.7% at 1 year, and 88.8 + 1.9% at 2 years, respectively. Conclusion Endovascular Stent–Graft placement in type B-AD is technically feasible with success rates of .95% in selected cohort. Although minimally invasive, major complications occurred in 14–18% of patients depending upon the acuity of presentation, with very low incidence of paraplegia. Both, acute and mid-term mortality of this novel treatment strategy appear to favourably compare with surgical treatment but further studies are necessary to compare Stent–Graft placement with medical treatment in uncomplicated AD.
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Stent-Graft implantation in the thoracic aorta. Results of an interdisciplinary survey in Germany
DMW - Deutsche Medizinische Wochenschrift, 2006Co-Authors: Holger Eggebrecht, Christoph A. Nienaber, Pamler R, Zipfel B, Herold U, Chavan A, Tim C. Rehders, Roland Hetzer, Heinz Jakob, Raimund ErbelAbstract:BACKGROUND AND OBJECTIVE Endovascular Stent-Graft placement is emerging as a novel therapeutic option in patients with disease of the descending thoracic aorta. Quality standards for performing Stent-Graft procedures as well as for pre- and postoperative patient management are lacking, so far. It was the aim of this present survey to assess the current therapeutic standard of thoracic aortic Stent-Graft placement in Germany. METHODS In a nationwide survey, a total of 206 vascular surgical, radiologic, cardiologic, and cardiothoracic surgical departments were contacted. Data concerning preoperative procedure planning, logistics, practical/technical issues of Stent-Graft placement, and postoperative patient management were evaluated using a standardized questionnaire comprising 29 items. Data analysis was performed using univariate analysis. RESULTS 184 (89.3 %) of the 206 departments participated in the survey. Of these, 71 centers reported intending to perform or having performed thoracic aortic Stent-Graft placement. The survey overall represents 2267 endovascular Stent-Graft procedures performed in Germany between 1997/98 and 2003. On average, 7.4 Stent-Graft procedures/year were performed by each center, with half the centers performing fewer than 5 procedures/year. Thoracic aortic aneurysms was the main indication for endovascular Stent-Graft placement, followed by aortic dissection. There were significant differences between the different medical specialties which perform Stent-Graft procedures with respect to indications, choice of preoperative and intraoperative imaging methods, and technical equipment. There was strong agreement between the different centers concerning the necessity of a life-long follow-up after Stent-Graft placement, with computed tomography being the preferred imaging technique (90 % of centers). CONCLUSION The present survey documents an increasing use of endovascular Stent-Graft placement in patients with disease of the descending thoracic aorta. There were differences regarding the technical execution of this procedures between specialties with respect to indication, procedure planning, and practical-technical aspects of Stent-Graft placement.
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aortoesophageal fistula secondary to Stent Graft repair of the thoracic aorta
Journal of Endovascular Therapy, 2004Co-Authors: Holger Eggebrecht, Heinz Jakob, Dietrich Baumgart, Ulf Herold, Klaus Radecke, Clemens Von Birgelen, Ulrich Treichel, Peter Hunold, Guido Gerken, Raimund ErbelAbstract:Purpose:To report the incidence and management of aortoesophageal fistula (AEF) secondary to endovascular Stent-Graft repair of the descending thoracic aorta.Methods:A retrospective review was cond...
Holger Eggebrecht - One of the best experts on this subject based on the ideXlab platform.
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thoracic aortic aneurysm expansion due to late distal Stent Graft induced new entry
Catheterization and Cardiovascular Interventions, 2015Co-Authors: Rolf Alexander Janosi, Holger Eggebrecht, Heinz Jakob, Konstantinos Tsagakis, Markus Bettin, Philipp Kahlert, Michael Horacek, Fadi Alrashid, Thomas Schlosser, Raimund ErbelAbstract:Objectives: This study analyzed the mechanism and risk factors of thoracic aortic aneurysm expansion due to late distal Stent Graft-induced new entry (dSINE). Background: This late complication of thoracic endovascular aneurysm repair (TEVAR) for aortic dissection is under-recognized but potentially life-threatening. Methods: In 142 patients who underwent TEVAR with endovascular entry sealing for acute and chronic aortic type B dissection, using commercially available straight (nontapered) StentGrafts, we examined the oversizing rate, the aortic taper ratio, and the need for reintervention. Results: Nine of 142 patients developed thoracic aortic aneurysm expansion due to dSINE after TEVAR. The median follow-up was 47.5637.4 months. There was a significant difference in the distal Stent‐aorta angle between the patients with and without dSINE (149.08615.09 ! vs. 166.72612.47 ! , P<0.005). Patients with dSINE showed a significantly higher taper ratio of the true lumen of the aorta (40.9614.13% vs. 25.36620.2%, P<0.05). There was also a significant difference in the oversizing of the Stent-Graft in the distal landing zone (95.88649.3% vs. 55.94636.23%, P<0.01). All patients with dSINE underwent a secondary endoGraft procedure without any complications or deaths. In 7 cases we used a custom-made, highly tapered Stent-Graft. Conclusions: Lifelong follow-up of patients is mandatory after TEVAR. A Stent-Graft with a tapered design should be used in aortic dissection to avoid oversizing and devastating late complications. V C 2014 Wiley Periodicals, Inc.
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endovascular Stent Graft placement in aortic dissection a meta analysis
European Heart Journal, 2006Co-Authors: Holger Eggebrecht, Christoph A. Nienaber, Tim C. Rehders, Heinz Jakob, Markus Neuhauser, Dietrich Baumgart, Stephan Kische, Axel Schmermund, Ulf Herold, Raimund ErbelAbstract:Aims This article summarizes all available published data with respect to clinical success, complications, and outcomes of endovascular Stent–Graft placement among patients with descending aortic dissection (AD). Methods and results We performed a meta-analysis of all published series on retrograde endovascular Stent–Graft placement encompassing � 3 patients with AD. Thirty-nine studies, involving a total of 609 patients, were included. Procedural success was reported in 98.2+ 0.5% of patients. Major complications were reported in 11.1+ 1.4%, with the most dreaded neurologic complications in 2.9 + 0.7% patients. Periprocedural stroke was encountered more frequently than paraplegia (1.9+ 0.6% vs. 0.8+ 0.4%). Overall complications were significantly higher in patients undergoing Stent–Graft placement for acute AD than in patients with chronic AD (21.7 + 2.8% vs. 9.1+ 2.3%, P ¼ 0.005). The overall 30-day mortality was 5.3+ 0.9%, and was three-fold higher in patients with acute AD when compared with chronic AD (9.8 + 2.2% vs. 3.2+ 1.4%, P ¼ 0.015). In addition, 2.8 + 0.7% of patients died over a mean follow-up period of 19.5 + 7.1 months. Kaplan–Meier analysis yielded overall survival rates of 90.6+ 1.6% at 6 months, 89.9+ 1.7% at 1 year, and 88.8 + 1.9% at 2 years, respectively. Conclusion Endovascular Stent–Graft placement in type B-AD is technically feasible with success rates of .95% in selected cohort. Although minimally invasive, major complications occurred in 14–18% of patients depending upon the acuity of presentation, with very low incidence of paraplegia. Both, acute and mid-term mortality of this novel treatment strategy appear to favourably compare with surgical treatment but further studies are necessary to compare Stent–Graft placement with medical treatment in uncomplicated AD.
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Stent-Graft implantation in the thoracic aorta. Results of an interdisciplinary survey in Germany
DMW - Deutsche Medizinische Wochenschrift, 2006Co-Authors: Holger Eggebrecht, Christoph A. Nienaber, Pamler R, Zipfel B, Herold U, Chavan A, Tim C. Rehders, Roland Hetzer, Heinz Jakob, Raimund ErbelAbstract:BACKGROUND AND OBJECTIVE Endovascular Stent-Graft placement is emerging as a novel therapeutic option in patients with disease of the descending thoracic aorta. Quality standards for performing Stent-Graft procedures as well as for pre- and postoperative patient management are lacking, so far. It was the aim of this present survey to assess the current therapeutic standard of thoracic aortic Stent-Graft placement in Germany. METHODS In a nationwide survey, a total of 206 vascular surgical, radiologic, cardiologic, and cardiothoracic surgical departments were contacted. Data concerning preoperative procedure planning, logistics, practical/technical issues of Stent-Graft placement, and postoperative patient management were evaluated using a standardized questionnaire comprising 29 items. Data analysis was performed using univariate analysis. RESULTS 184 (89.3 %) of the 206 departments participated in the survey. Of these, 71 centers reported intending to perform or having performed thoracic aortic Stent-Graft placement. The survey overall represents 2267 endovascular Stent-Graft procedures performed in Germany between 1997/98 and 2003. On average, 7.4 Stent-Graft procedures/year were performed by each center, with half the centers performing fewer than 5 procedures/year. Thoracic aortic aneurysms was the main indication for endovascular Stent-Graft placement, followed by aortic dissection. There were significant differences between the different medical specialties which perform Stent-Graft procedures with respect to indications, choice of preoperative and intraoperative imaging methods, and technical equipment. There was strong agreement between the different centers concerning the necessity of a life-long follow-up after Stent-Graft placement, with computed tomography being the preferred imaging technique (90 % of centers). CONCLUSION The present survey documents an increasing use of endovascular Stent-Graft placement in patients with disease of the descending thoracic aorta. There were differences regarding the technical execution of this procedures between specialties with respect to indication, procedure planning, and practical-technical aspects of Stent-Graft placement.
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aortoesophageal fistula secondary to Stent Graft repair of the thoracic aorta
Journal of Endovascular Therapy, 2004Co-Authors: Holger Eggebrecht, Heinz Jakob, Dietrich Baumgart, Ulf Herold, Klaus Radecke, Clemens Von Birgelen, Ulrich Treichel, Peter Hunold, Guido Gerken, Raimund ErbelAbstract:Purpose:To report the incidence and management of aortoesophageal fistula (AEF) secondary to endovascular Stent-Graft repair of the descending thoracic aorta.Methods:A retrospective review was cond...
Christoph A. Nienaber - One of the best experts on this subject based on the ideXlab platform.
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endovascular Stent Graft placement in aortic dissection a meta analysis
European Heart Journal, 2006Co-Authors: Holger Eggebrecht, Christoph A. Nienaber, Tim C. Rehders, Heinz Jakob, Markus Neuhauser, Dietrich Baumgart, Stephan Kische, Axel Schmermund, Ulf Herold, Raimund ErbelAbstract:Aims This article summarizes all available published data with respect to clinical success, complications, and outcomes of endovascular Stent–Graft placement among patients with descending aortic dissection (AD). Methods and results We performed a meta-analysis of all published series on retrograde endovascular Stent–Graft placement encompassing � 3 patients with AD. Thirty-nine studies, involving a total of 609 patients, were included. Procedural success was reported in 98.2+ 0.5% of patients. Major complications were reported in 11.1+ 1.4%, with the most dreaded neurologic complications in 2.9 + 0.7% patients. Periprocedural stroke was encountered more frequently than paraplegia (1.9+ 0.6% vs. 0.8+ 0.4%). Overall complications were significantly higher in patients undergoing Stent–Graft placement for acute AD than in patients with chronic AD (21.7 + 2.8% vs. 9.1+ 2.3%, P ¼ 0.005). The overall 30-day mortality was 5.3+ 0.9%, and was three-fold higher in patients with acute AD when compared with chronic AD (9.8 + 2.2% vs. 3.2+ 1.4%, P ¼ 0.015). In addition, 2.8 + 0.7% of patients died over a mean follow-up period of 19.5 + 7.1 months. Kaplan–Meier analysis yielded overall survival rates of 90.6+ 1.6% at 6 months, 89.9+ 1.7% at 1 year, and 88.8 + 1.9% at 2 years, respectively. Conclusion Endovascular Stent–Graft placement in type B-AD is technically feasible with success rates of .95% in selected cohort. Although minimally invasive, major complications occurred in 14–18% of patients depending upon the acuity of presentation, with very low incidence of paraplegia. Both, acute and mid-term mortality of this novel treatment strategy appear to favourably compare with surgical treatment but further studies are necessary to compare Stent–Graft placement with medical treatment in uncomplicated AD.
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Stent-Graft implantation in the thoracic aorta. Results of an interdisciplinary survey in Germany
DMW - Deutsche Medizinische Wochenschrift, 2006Co-Authors: Holger Eggebrecht, Christoph A. Nienaber, Pamler R, Zipfel B, Herold U, Chavan A, Tim C. Rehders, Roland Hetzer, Heinz Jakob, Raimund ErbelAbstract:BACKGROUND AND OBJECTIVE Endovascular Stent-Graft placement is emerging as a novel therapeutic option in patients with disease of the descending thoracic aorta. Quality standards for performing Stent-Graft procedures as well as for pre- and postoperative patient management are lacking, so far. It was the aim of this present survey to assess the current therapeutic standard of thoracic aortic Stent-Graft placement in Germany. METHODS In a nationwide survey, a total of 206 vascular surgical, radiologic, cardiologic, and cardiothoracic surgical departments were contacted. Data concerning preoperative procedure planning, logistics, practical/technical issues of Stent-Graft placement, and postoperative patient management were evaluated using a standardized questionnaire comprising 29 items. Data analysis was performed using univariate analysis. RESULTS 184 (89.3 %) of the 206 departments participated in the survey. Of these, 71 centers reported intending to perform or having performed thoracic aortic Stent-Graft placement. The survey overall represents 2267 endovascular Stent-Graft procedures performed in Germany between 1997/98 and 2003. On average, 7.4 Stent-Graft procedures/year were performed by each center, with half the centers performing fewer than 5 procedures/year. Thoracic aortic aneurysms was the main indication for endovascular Stent-Graft placement, followed by aortic dissection. There were significant differences between the different medical specialties which perform Stent-Graft procedures with respect to indications, choice of preoperative and intraoperative imaging methods, and technical equipment. There was strong agreement between the different centers concerning the necessity of a life-long follow-up after Stent-Graft placement, with computed tomography being the preferred imaging technique (90 % of centers). CONCLUSION The present survey documents an increasing use of endovascular Stent-Graft placement in patients with disease of the descending thoracic aorta. There were differences regarding the technical execution of this procedures between specialties with respect to indication, procedure planning, and practical-technical aspects of Stent-Graft placement.
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nonsurgical reconstruction of thoracic aortic dissection by Stent Graft placement
The New England Journal of Medicine, 1999Co-Authors: Christoph A. Nienaber, Christoph Dieckmann, Yskert Von Kodolitsch, Gunnar K. Lund, V. Nicolas, Rossella Fattori, Walter Wolf, Alessandra PierangeliAbstract:Background The treatment of thoracic aortic dissection is guided by prognostic and anatomical information. Proximal dissection requires surgery, but the appropriate treatment of distal thoracic aortic dissection has not been determined, because surgery has failed to improve the prognosis. Methods We prospectively evaluated the safety and efficacy of elective transluminal endovascular Stent–Graft insertion in 12 consecutive patients with descending (type B) aortic dissection and compared the results with surgery in 12 matched controls. In all 24 patients, aortic dissection was diagnosed by magnetic resonance angiography. In each group, the dissection involved the aortic arch in 3 patients and the descending thoracic aorta in all 12 patients. With the patient under general anesthesia, either surgical resection was undertaken or a custom-designed endovascular Stent–Graft was placed by unilateral arteriotomy. Results Stent–Graft placement resulted in no morbidity or mortality, whereas surgery for type B disse...
Alessandra Pierangeli - One of the best experts on this subject based on the ideXlab platform.
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nonsurgical reconstruction of thoracic aortic dissection by Stent Graft placement
The New England Journal of Medicine, 1999Co-Authors: Christoph A. Nienaber, Christoph Dieckmann, Yskert Von Kodolitsch, Gunnar K. Lund, V. Nicolas, Rossella Fattori, Walter Wolf, Alessandra PierangeliAbstract:Background The treatment of thoracic aortic dissection is guided by prognostic and anatomical information. Proximal dissection requires surgery, but the appropriate treatment of distal thoracic aortic dissection has not been determined, because surgery has failed to improve the prognosis. Methods We prospectively evaluated the safety and efficacy of elective transluminal endovascular Stent–Graft insertion in 12 consecutive patients with descending (type B) aortic dissection and compared the results with surgery in 12 matched controls. In all 24 patients, aortic dissection was diagnosed by magnetic resonance angiography. In each group, the dissection involved the aortic arch in 3 patients and the descending thoracic aorta in all 12 patients. With the patient under general anesthesia, either surgical resection was undertaken or a custom-designed endovascular Stent–Graft was placed by unilateral arteriotomy. Results Stent–Graft placement resulted in no morbidity or mortality, whereas surgery for type B disse...
Heinz Jakob - One of the best experts on this subject based on the ideXlab platform.
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thoracic aortic aneurysm expansion due to late distal Stent Graft induced new entry
Catheterization and Cardiovascular Interventions, 2015Co-Authors: Rolf Alexander Janosi, Holger Eggebrecht, Heinz Jakob, Konstantinos Tsagakis, Markus Bettin, Philipp Kahlert, Michael Horacek, Fadi Alrashid, Thomas Schlosser, Raimund ErbelAbstract:Objectives: This study analyzed the mechanism and risk factors of thoracic aortic aneurysm expansion due to late distal Stent Graft-induced new entry (dSINE). Background: This late complication of thoracic endovascular aneurysm repair (TEVAR) for aortic dissection is under-recognized but potentially life-threatening. Methods: In 142 patients who underwent TEVAR with endovascular entry sealing for acute and chronic aortic type B dissection, using commercially available straight (nontapered) StentGrafts, we examined the oversizing rate, the aortic taper ratio, and the need for reintervention. Results: Nine of 142 patients developed thoracic aortic aneurysm expansion due to dSINE after TEVAR. The median follow-up was 47.5637.4 months. There was a significant difference in the distal Stent‐aorta angle between the patients with and without dSINE (149.08615.09 ! vs. 166.72612.47 ! , P<0.005). Patients with dSINE showed a significantly higher taper ratio of the true lumen of the aorta (40.9614.13% vs. 25.36620.2%, P<0.05). There was also a significant difference in the oversizing of the Stent-Graft in the distal landing zone (95.88649.3% vs. 55.94636.23%, P<0.01). All patients with dSINE underwent a secondary endoGraft procedure without any complications or deaths. In 7 cases we used a custom-made, highly tapered Stent-Graft. Conclusions: Lifelong follow-up of patients is mandatory after TEVAR. A Stent-Graft with a tapered design should be used in aortic dissection to avoid oversizing and devastating late complications. V C 2014 Wiley Periodicals, Inc.
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endovascular Stent Graft placement in aortic dissection a meta analysis
European Heart Journal, 2006Co-Authors: Holger Eggebrecht, Christoph A. Nienaber, Tim C. Rehders, Heinz Jakob, Markus Neuhauser, Dietrich Baumgart, Stephan Kische, Axel Schmermund, Ulf Herold, Raimund ErbelAbstract:Aims This article summarizes all available published data with respect to clinical success, complications, and outcomes of endovascular Stent–Graft placement among patients with descending aortic dissection (AD). Methods and results We performed a meta-analysis of all published series on retrograde endovascular Stent–Graft placement encompassing � 3 patients with AD. Thirty-nine studies, involving a total of 609 patients, were included. Procedural success was reported in 98.2+ 0.5% of patients. Major complications were reported in 11.1+ 1.4%, with the most dreaded neurologic complications in 2.9 + 0.7% patients. Periprocedural stroke was encountered more frequently than paraplegia (1.9+ 0.6% vs. 0.8+ 0.4%). Overall complications were significantly higher in patients undergoing Stent–Graft placement for acute AD than in patients with chronic AD (21.7 + 2.8% vs. 9.1+ 2.3%, P ¼ 0.005). The overall 30-day mortality was 5.3+ 0.9%, and was three-fold higher in patients with acute AD when compared with chronic AD (9.8 + 2.2% vs. 3.2+ 1.4%, P ¼ 0.015). In addition, 2.8 + 0.7% of patients died over a mean follow-up period of 19.5 + 7.1 months. Kaplan–Meier analysis yielded overall survival rates of 90.6+ 1.6% at 6 months, 89.9+ 1.7% at 1 year, and 88.8 + 1.9% at 2 years, respectively. Conclusion Endovascular Stent–Graft placement in type B-AD is technically feasible with success rates of .95% in selected cohort. Although minimally invasive, major complications occurred in 14–18% of patients depending upon the acuity of presentation, with very low incidence of paraplegia. Both, acute and mid-term mortality of this novel treatment strategy appear to favourably compare with surgical treatment but further studies are necessary to compare Stent–Graft placement with medical treatment in uncomplicated AD.
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Stent-Graft implantation in the thoracic aorta. Results of an interdisciplinary survey in Germany
DMW - Deutsche Medizinische Wochenschrift, 2006Co-Authors: Holger Eggebrecht, Christoph A. Nienaber, Pamler R, Zipfel B, Herold U, Chavan A, Tim C. Rehders, Roland Hetzer, Heinz Jakob, Raimund ErbelAbstract:BACKGROUND AND OBJECTIVE Endovascular Stent-Graft placement is emerging as a novel therapeutic option in patients with disease of the descending thoracic aorta. Quality standards for performing Stent-Graft procedures as well as for pre- and postoperative patient management are lacking, so far. It was the aim of this present survey to assess the current therapeutic standard of thoracic aortic Stent-Graft placement in Germany. METHODS In a nationwide survey, a total of 206 vascular surgical, radiologic, cardiologic, and cardiothoracic surgical departments were contacted. Data concerning preoperative procedure planning, logistics, practical/technical issues of Stent-Graft placement, and postoperative patient management were evaluated using a standardized questionnaire comprising 29 items. Data analysis was performed using univariate analysis. RESULTS 184 (89.3 %) of the 206 departments participated in the survey. Of these, 71 centers reported intending to perform or having performed thoracic aortic Stent-Graft placement. The survey overall represents 2267 endovascular Stent-Graft procedures performed in Germany between 1997/98 and 2003. On average, 7.4 Stent-Graft procedures/year were performed by each center, with half the centers performing fewer than 5 procedures/year. Thoracic aortic aneurysms was the main indication for endovascular Stent-Graft placement, followed by aortic dissection. There were significant differences between the different medical specialties which perform Stent-Graft procedures with respect to indications, choice of preoperative and intraoperative imaging methods, and technical equipment. There was strong agreement between the different centers concerning the necessity of a life-long follow-up after Stent-Graft placement, with computed tomography being the preferred imaging technique (90 % of centers). CONCLUSION The present survey documents an increasing use of endovascular Stent-Graft placement in patients with disease of the descending thoracic aorta. There were differences regarding the technical execution of this procedures between specialties with respect to indication, procedure planning, and practical-technical aspects of Stent-Graft placement.
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aortoesophageal fistula secondary to Stent Graft repair of the thoracic aorta
Journal of Endovascular Therapy, 2004Co-Authors: Holger Eggebrecht, Heinz Jakob, Dietrich Baumgart, Ulf Herold, Klaus Radecke, Clemens Von Birgelen, Ulrich Treichel, Peter Hunold, Guido Gerken, Raimund ErbelAbstract:Purpose:To report the incidence and management of aortoesophageal fistula (AEF) secondary to endovascular Stent-Graft repair of the descending thoracic aorta.Methods:A retrospective review was cond...