VASCULAR BYPASS GRAFTING COMBINED WITH ENDOVASCULAR AORTIC REPAIR FOR TREATMENT OFAORTIC DILATATION DISEASE_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

ZHANG Zhenlong , QIU Hanfan , CHEN Liangwan , CHEN Daozhong , HUANG Xueshan , CAO Hua , LIN Feng , HUANG Zhongyao.

Institute of Cardiothoracic Surgery of Fujian Province &;
Department of Cardiac Surgery,the Affiliated Union Hospital, Fujian Medical University, Fuzhou Fujian, 350001, P.R.China.;

Corresponding author：

Keywords：

Aortic dilatation disease, Endovascular aortic repair ,Vascular bypass grafting

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Objective To summarize the cl inical experience of vascular bypass grafting combined with endovascular
aortic repair (EVAR) for aortic dilatation disease. Methods Between January 2008 and August 2011, 12 patients with aortic
dilatation disease were treated with vascular bypass grafting combined with EVAR. Of 12 patients, 11 were male and 1 was
female, aged 47-81 years (mean, 65.9 years). All cases were diagnosed through computed tomography angiography (CTA),
including 1 case of Stanford type A dissection, 5 cases of Stanford type B dissection, 4 cases of aortic arch aneurysm, and 2 cases
of abdominal aortic aneurysm. Eight patients received neck artery bypass grafting before EVAR, and 4 patients underwent
femoral artery bypass grafting after EVAR. Results After operation, pulmonary infection occurred in 3 patients, renal
insufficiency in 2 patients, cerebral infarction in 1 case, decreased hemoglobin and platelets in 7 cases, and poor healing of groin
wound in 1 case. Eleven patients were followed up 3-42 months, with an average of 18.6 months. In 1 case undergoing EVAR
of the thoracic and abdominal aorta, EVAR was performed again because new aneurysms formed at 6 months after operation,
and the patient achieved good recovery after 3 months. CTA showed reduced false lumen, thrombosis formation, no endoleak,
no deformation or displacement of stent, and anastomotic patency of artificial blood vessels in the other patients at 3, 6, and
12 months after operation. Conclusion Vascular bypass grafting combined with EVAR can expand the indications for
endovascular repair. It not only provides sufficient anchoring area, but also ensures the blood supply to vital organs, simplifies
the surgical procedure, and reduces the difficulty of endovascular treatment.

Citation： ZHANG Zhenlong,QIU Hanfan,CHEN Liangwan,CHEN Daozhong,HUANG Xueshan,CAO Hua,LIN Feng,HUANG Zhongyao.. VASCULAR BYPASS GRAFTING COMBINED WITH ENDOVASCULAR AORTIC REPAIR FOR TREATMENT OFAORTIC DILATATION DISEASE. Chinese Journal of Reparative and Reconstructive Surgery, 2012, 26(5): 583-586. doi: Copy

1.	符伟国, 岳嘉宁. 胸腹主动脉瘤杂交技术应用. 中国普外基础与临床杂志, 2011, 18(10): 1024-1026.
2.	Ehsan O, Murray D, Farquharson F, et al. Endovascular repair of complex aortic aneurysms. Ann Vasc Surg, 2011, 25(5): 716-725.
3.	中华医学会外科学分会血管外科学组. 主动脉夹层腔内治疗指南. 中国实用外科杂志, 2008, 28(11): 909-912.
4.	Etezadi V, Schiro B, Peña CS, et al. Endovascular treatment of descending thoracic aortic disease: Single-Center, 15-Year experience. J Vasc Interv Radiol, 2012, 31(2): 78-83.
5.	Thrumurthy SG, Karthikesalingam A, Patterson BO, et al. A systematic review of mid-term outcomes of thoracic endovascular repair (TEVAR) of chronic type B aortic dissection. Eur J Vasc Endovasc Surg, 2011, 42(5): 632-647.
6.	景在平, 陆清声. 主动脉弓疾病的腔内及杂交治疗. 中国血管外科杂志 (电子版), 2010, 2(3): 133-135.
7.	Antoniou GA, El Sakka K, Hamady M, et al. Hybrid treatment of complex aortic arch disease with supra-aortic debranching and endovascular stent graft repair. Eur J Vasc Endovasc Surg, 2010, 39(6): 683-690.
8.	Ingrund JC, Nasser F, Jesus-Silva SG, et al. Hybrid procedures for complex thoracic aortic diseases. Rev Bras Cir Cardiovasc, 2010, 25(3): 303-310.
9.	Bakoyiannis C, Kalles V, Economopoulos K, et al. Hybrid procedures in the treatment of thoracoabdominal aortic aneurysms: a systematic review. J Endovasc Ther, 2009, 16(4): 443-450.
10.	Patel HJ, Upchurch GR Jr, Eliason JL, et al. Hybrid debranching with endovascular repair for thoracoabdominal aneurysms: a comparison with open repair. Ann Thorac Surg, 2010, 89(5): 1475-1481.
11.	Vallejo N, Rodriguez-Lopez JA, Heidari P, et al. Hybrid repair of thoracic aortic lesions for zone 0 and 1 in high-risk patients. Vasc Surg, 2012, 55(2): 318-325.
12.	Szeto WY, Bavaria JE, Bowen FW, et al. The hybrid total arch repair: brachiocephalic bypass and concomitant endovascular aortic arch stent graft placement. J Card Surg, 2007, 22(2): 97-102.
13.	Holt PJ, Johnson C, Hinchliffe RJ, et al. Outcomes of the endovascular management of aortic arch aneurysm: implications for management of the left subclavian artery. J Vasc Surg, 2010, 51(6): 1329-1338.
14.	Chung J, Kasirajan K, Veeraswamy RK, et al. Left subclavian artery coverage during thoracic endovascular aortic repair and risk of perioperative stroke or death. J Vasc Surg, 2011, 54(4): 979-984.
15.	Lee TC, Andersen ND, Williams JB, et al. Results with a selective revascularization strategy for left subclavian artery coverage during thoracic endovascular aortic repair. Ann Thorac Surg, 2011, 92(1): 97-102.
16.	Feezor RJ, Lee WA. Management of the left subclavian artery during TEVAR. Semin Vasc Surg, 2009, 22(3): 159-164.
17.	Böckler D, Kotelis D, Geisbüsch P, et al. Hybrid procedures for thoracoabdominal aortic aneurysms and chronic aortic dissections——a single center experience in 28 patients. J Vasc Surg, 2008, 47(4): 724-732.
18.	Farber MA, Ford PF. Hybrid procedures for thoracoabdominal aortic aneurysms. Semin Vasc Surg, 2009, 22(3): 140-144.
19.	张宏鹏, 郭伟, 刘小平, 等. 杂交技术治疗胸腹主动脉瘤. 中华外科杂志, 2009, 47(9): 657-660.
20.	Zheng YH, Choi N, Deng HR, et al. Hybrid endovascular aorta repair with simultaneous supra-aortic branch or iliac branch revascularization. Chinese medical sciences journal, 2009, 24(3): 182-185.

1. 符伟国, 岳嘉宁. 胸腹主动脉瘤杂交技术应用. 中国普外基础与临床杂志, 2011, 18(10): 1024-1026.
2. Ehsan O, Murray D, Farquharson F, et al. Endovascular repair of complex aortic aneurysms. Ann Vasc Surg, 2011, 25(5): 716-725.
3. 中华医学会外科学分会血管外科学组. 主动脉夹层腔内治疗指南. 中国实用外科杂志, 2008, 28(11): 909-912.
4. Etezadi V, Schiro B, Peña CS, et al. Endovascular treatment of descending thoracic aortic disease: Single-Center, 15-Year experience. J Vasc Interv Radiol, 2012, 31(2): 78-83.
5. Thrumurthy SG, Karthikesalingam A, Patterson BO, et al. A systematic review of mid-term outcomes of thoracic endovascular repair (TEVAR) of chronic type B aortic dissection. Eur J Vasc Endovasc Surg, 2011, 42(5): 632-647.
6. 景在平, 陆清声. 主动脉弓疾病的腔内及杂交治疗. 中国血管外科杂志 (电子版), 2010, 2(3): 133-135.
7. Antoniou GA, El Sakka K, Hamady M, et al. Hybrid treatment of complex aortic arch disease with supra-aortic debranching and endovascular stent graft repair. Eur J Vasc Endovasc Surg, 2010, 39(6): 683-690.
8. Ingrund JC, Nasser F, Jesus-Silva SG, et al. Hybrid procedures for complex thoracic aortic diseases. Rev Bras Cir Cardiovasc, 2010, 25(3): 303-310.
9. Bakoyiannis C, Kalles V, Economopoulos K, et al. Hybrid procedures in the treatment of thoracoabdominal aortic aneurysms: a systematic review. J Endovasc Ther, 2009, 16(4): 443-450.
10. Patel HJ, Upchurch GR Jr, Eliason JL, et al. Hybrid debranching with endovascular repair for thoracoabdominal aneurysms: a comparison with open repair. Ann Thorac Surg, 2010, 89(5): 1475-1481.
11. Vallejo N, Rodriguez-Lopez JA, Heidari P, et al. Hybrid repair of thoracic aortic lesions for zone 0 and 1 in high-risk patients. Vasc Surg, 2012, 55(2): 318-325.
12. Szeto WY, Bavaria JE, Bowen FW, et al. The hybrid total arch repair: brachiocephalic bypass and concomitant endovascular aortic arch stent graft placement. J Card Surg, 2007, 22(2): 97-102.
13. Holt PJ, Johnson C, Hinchliffe RJ, et al. Outcomes of the endovascular management of aortic arch aneurysm: implications for management of the left subclavian artery. J Vasc Surg, 2010, 51(6): 1329-1338.
14. Chung J, Kasirajan K, Veeraswamy RK, et al. Left subclavian artery coverage during thoracic endovascular aortic repair and risk of perioperative stroke or death. J Vasc Surg, 2011, 54(4): 979-984.
15. Lee TC, Andersen ND, Williams JB, et al. Results with a selective revascularization strategy for left subclavian artery coverage during thoracic endovascular aortic repair. Ann Thorac Surg, 2011, 92(1): 97-102.
16. Feezor RJ, Lee WA. Management of the left subclavian artery during TEVAR. Semin Vasc Surg, 2009, 22(3): 159-164.
17. Böckler D, Kotelis D, Geisbüsch P, et al. Hybrid procedures for thoracoabdominal aortic aneurysms and chronic aortic dissections——a single center experience in 28 patients. J Vasc Surg, 2008, 47(4): 724-732.
18. Farber MA, Ford PF. Hybrid procedures for thoracoabdominal aortic aneurysms. Semin Vasc Surg, 2009, 22(3): 140-144.
19. 张宏鹏, 郭伟, 刘小平, 等. 杂交技术治疗胸腹主动脉瘤. 中华外科杂志, 2009, 47(9): 657-660.
20. Zheng YH, Choi N, Deng HR, et al. Hybrid endovascular aorta repair with simultaneous supra-aortic branch or iliac branch revascularization. Chinese medical sciences journal, 2009, 24(3): 182-185.

Chinese Journal of Reparative and Reconstructive Surgery

VASCULAR BYPASS GRAFTING COMBINED WITH ENDOVASCULAR AORTIC REPAIR FOR TREATMENT OFAORTIC DILATATION DISEASE

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