15.48-15.55 Endoprtesis paralelas: El camino ms corto a seguir
para el tratamiento de terapias articas complejas Parallel grafts
are the shorter way to go in complex aortic therapy M. Lachat
AuthorYearPatients30d ResultsFUPParallel graftsdeathstroke
and/or
paraplegiaELreinterventionreinterventionsurvivalMangialardi2014261263-80%@3yearsVicente2014100000100%@0.8yearsSynoviecz2013100000-Shahverdyan201361032183%@0.2yearsSamura2013200200100%@0.5yearsZhu2013340024494%@1yearChang2013100000100%@1yearZhou2013100200100%@1yearVallejo2012811035-Akchurin20121000100100%@0.5yearsCires2011911013100%@0.4yearsYoshida2011200201-Shu2011800000100%@1yearFeng2011100000100%@1yearGehringhoff201191010179%@1yearSugiura20091121201-Baldwin2008701100-Ohrlander2008400212Criado2007800000-Hiramoto2006100000-Larzon2005200200-Total15276261418%541791294%@1year
AuthorYearPatients30d ResultsFUPConventional Open
Repairdeathstroke and/or
paraplegiaELreinterventionreinterventionsurvivalAndersen20122021-3051@[email protected]%@5yDi
eusanio20131222120-15097%@1yFlores20062538----Hofferberth20121913-04-Hoffmann20123211-40-Ius20131312015-24072%@5yJakob20112704135-38074%@5yJim2011101120150%@3YKawaharada2009312110473%@5YLee20112143205-Leontyev201346411-6068%@5yLima2012504612087%@2YNishi20116126-03-Pochettino20093651----Roselli20131702----Shen20123832---91%@5yShi20114611-20-Shimamura2008126411-3063%@5yShimamura2009695662689%@3YShrestha20123431-62-Sun20133983120-280-Uchida20118037-20-Usui20022404---96%@1yearXiao201333600---Zhao2012241110192%@5YTotal18301761801313529%10105,581,879%@4years
AuthorYearDevicePatients30d ResultsFUPF/BEVARdeathstroke and/or
paraplegiaELreinterventionreinterventionsurvivalInoue
K1999BEVAR-Inoue150141487%@1yearMcWilliams2004FEVAR100000100%@0.5YearSaito
N2005BEVAR-Inoue170130288%@2.2yearsChuter T2003BEVAR100000-Brar
R2008BEVAR100000-Kawaguchi2008FEVAR288-16---62%@5yearsSonesson2009FEVAR10000-100%@0.1YearManning2010FEVAR1000000-Yusa2011FEVAR1000100-Lioupis2012BEVAR602210-Spear2013BEVAR10000--Azuma2013FEVAR39361012---Haulon2014BEVAR385643-Anderson2015FEVAR200000100%@0.5
yearsMatsuyama2015FEVAR3712101165%@5yearsMangialardi2015FEAVR-Najuta100000-Tse2015FEVAR-insitu601000-Kurimoto2015FEVAR3705120486%@2yearsTotal865124435624%1,5540,7386%@2years
Zone I pathology
Zone 0 pathology
??J/PRAA
Short-term results PG-EVARF/BEVARSurgeryRenal
failure0-12.9%7-22%18-22%ICU stay22-44-5Hospital
stay108-1311-16Paraplegia20-31%6Stroke0-303Long term results
PG-EVARF/BEVARSurgeryBranch patency96%
(5-years)90-99%85-100%Endoleak I/III5%0-5%-Stentgraft
migration00-1%-Redos28%15-25%5-8%
Considering similar 30-day mortality rates!
PG-EVAR
Author, yearPtE/Un artRASMACTMort (30-d)Morb (30-d)EL ISGLarzon,
200813614140001-0Ohrlander, 2008651192011-7Hiramoto,
20092903131000301Bruen, 20102103527801010Kolvenbach,
20105517---01017Bruen, 201121037289016131Coscas,
201116426206021240Lee, 201228057486326245Donas,
201230-3835300-035Schiro, 2013909900001-Tolenaar,
201313-22---020-Fukui,2013100101000000-Liu, 20135066000001Suominen,
201470111100030-Ducasse, 20142202222002320Banno,
201438661---315--Schwierz, 20143214104---25--Scali,
201441-7651169283-Bin Jarb, 2015291441---4-3-XiaoHui,
201542-56---0-82Ronchey, 2015232333294-0830Lachat,
2015*100272241613824215590Overall (%)540104 (22)941511923622
(4.1)70 (17)36 (8)299
Ref: reference; Pt: patients; E/U: emergent/urgent repair; n
art: number of artery; RA: renal artery; SMA: superior mesenteric
artery; CT: celiac trunk; Mort: mortality; Morb: morbidity; d:
days; EL I: endoleak type I; SG: stent graft. * unpublished
resultsPG-EVAR Literature review
15
PreopPostopFUPJRAA3.7 mm20.2 mm20.1 mmSRAA3.8 mm23.2 mm23.1
mmCraw IV5.1 mm21.9 mm22.0 mmTAAA3.5 mm22.6 mm22.3 mmOverall3.8
mm21.6 mm21.5 mm
Neck length (mean in mm). A significant increase in postop neck
length and FUP neck was observed for all the pathology group when
compared to the preoperative length. No differences between postop
neck length and FUP neck was observed100 consecutive PG-EVAR @
UHZMean neck length
Extra costs for fenestrated device
Costs comparison PG-EVAR vs FEVAR
Courtesy of K. Donas, Mnster
Additional vessels at risk
Outcomes29 +/-17 monthsMortality at FUPMAXTDCPG
patencyReinterventionsPRAA vs TAAA0.320.770.970.15Elective vs
nonelective0.0010.620.520.011-2 CPG vs 3-4 CPG0.030.170.840.06CG vs
PG vs CPG0.060.590.950.33Renal vs visceral vs
all0.720.120.410.40Aortic stentgraft0.960.120.860.08CPG stenosis
(>70%) and/orVery short CPGs (50%) or a diameter < 4
mm0.650.090.040.05
100 consecutive PG-EVAR @ UHZ
Paraplegia risk
Conclusions
PG-EVAR
sAAA
CP-EVAR (planning)
CP-EVAR result
ConclusionsPG-EVAR shows results equivalent to other repair
techniques
517 patients, 13 centres
ConclusionsIn comparison with F/BEVAR, PG-EVAR is simpler
procedure with less manipulations and devices and without the need
of covering unnecessary healthy aorta and eventually aortic
branches
Conclusions
Try to do this or you are welcome in ZurichThank You!
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