Journal of Vascular Surgery
Volume 50, Issue 6 , Pages 1255-1264.e4 , December 2009

A multicenter clinical trial of endovascular stent graft repair of acute catastrophes of the descending thoracic aorta

Presented in part at the Tenth Annual Meeting of the Society for Vascular Surgery, Baltimore, MD, June 7-10, 2007.

  • Richard P. Cambria, MD

      Affiliations

    • Division of Vascular and Endovascular Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, Mass
    • Corresponding Author InformationReprint requests: Richard P. Cambria, MD, Massachusetts General Hospital, 15 Parkman St, WAC 440, Boston, MA, 02114
    • ,
  • Robert S. Crawford, MD

      Affiliations

    • Division of Vascular and Endovascular Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, Mass
    • ,
  • Jae-Sung Cho, MD

      Affiliations

    • Division of Vascular Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pa
    • ,
  • Joseph Bavaria, MD

      Affiliations

    • Division of Cardiovascular Surgery, Department of Surgery, University of Pennsylvania School of Medicine, Philadelphia, Pa
    • ,
  • Mark Farber, MD

      Affiliations

    • Department of Surgery, Division of Vascular Surgery, University of North Carolina, Chapel Hill, NC
    • ,
  • W. Anthony Lee, MD

      Affiliations

    • Division of Vascular Surgery and Endovascular Therapy, University of Florida College of Medicine, Gainesville, Fla
    • ,
  • Venkatesh Ramaiah, MD

      Affiliations

    • Arizona Heart Institute, Phoenix, Ariz
    • ,
  • Christopher J. Kwolek, MD

      Affiliations

    • Division of Vascular and Endovascular Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, Mass
    • ,
  • GORE TAG Investigators

Received 6 May 2009 ,Accepted 25 July 2009.

References 

  1. Bavaria JE, Appoo JJ, Makaroun MS, Verter J, Yu ZF, Mitchell RS. Endovascular stent grafting versus open surgical repair of descending thoracic aortic aneurysms in low-risk patients: a multicenter comparative trial. J Thorac Cardiovasc Surg. 2007;133:369–377
  2. Matsumura JS, Cambria RP, Dake MD, Moore RD, Svensson LG, Snyder S. International controlled clinical trial of thoracic endovascular aneurysm repair with the Zenith TX2 endovascular graft: 1-year results. J Vasc Surg. 2008;47:247–257discussion 57
  3. Fairman RM, Criado F, Farber M, Kwolek C, Mehta M, White R, et al. Pivotal results of the Medtronic Vascular Talent Thoracic Stent Graft System: the VALOR trial. J Vasc Surg. 2008;48:546–554
  4. Makaroun MS, Dillavou ED, Kee ST, Sicard G, Chaikof E, Bavaria J, et al. Endovascular treatment of thoracic aortic aneurysms: results of the phase II multicenter trial of the GORE TAG thoracic endoprosthesis. J Vasc Surg. 2005;41:1–9
  5. Leurs LJ, Bell R, Degrieck Y, Thomas S, Hobo R, Lundbom J. Endovascular treatment of thoracic aortic diseases: combined experience from the EUROSTAR and United Kingdom Thoracic Endograft registries. J Vasc Surg. 2004;40:670–679discussion 9-80
  6. Hoffer EK, Forauer AR, Silas AM, Gemery JM. Endovascular stent-graft or open surgical repair for blunt thoracic aortic trauma: systematic review. J Vasc Interv Radiol. 2008;19:1153–1164
  7. Demetriades D, Velmahos GC, Scalea TM, Jurkovich GJ, Karmy-Jones R, Teixeira PG, et al. Operative repair or endovascular stent graft in blunt traumatic thoracic aortic injuries: results of an American Association for the Surgery of Trauma Multicenter Study. J Trauma. 2008;64:561–570discussion 70-1
  8. Parker JD, Golledge J. Outcome of endovascular treatment of acute type B aortic dissection. Ann Thorac Surg. 2008;86:1707–1712
  9. Szeto WY, McGarvey M, Pochettino A, Moser GW, Hoboken A, Cornelius K, et al. Results of a new surgical paradigm: endovascular repair for acute complicated type B aortic dissection. Ann Thorac Surg. 2008;86:87–93discussion 93-4
  10. Doss M, Balzer J, Martens S, Wood JP, Wimmer-Greinecker G, Fieguth HG, et al. Surgical versus endovascular treatment of acute thoracic aortic rupture: a single-center experience. Ann Thorac Surg. 2003;76:1465–1469discussion 1469-70
  11. Girardi LN, Krieger KH, Altorki NK, Mack CA, Lee LY, Isom OW. Ruptured descending and thoracoabdominal aortic aneurysms. Ann Thorac Surg. 2002;74:1066–1070
  12. Bates B. The nervous system (A guide to physical examination and history taking). Philadelphia, PA: J.B. Lippincott Company; 1987;
  13. Chaikof EL, Blankensteijn JD, Harris PL, White GH, Zarins CK, Bernhard VM, et al. Reporting standards for endovascular aortic aneurysm repair. J Vasc Surg. 2002;35:1048–1060
  14. Conrad MF, Crawford RS, Kwolek CK, Brewster DC, Brady TJ, Cambria RP. Aortic remodeling after endovascular repair of acute complicated type B aortic dissection. J Vasc Surg. 2009;50:510–517
  15. Barbato JE, Kim JY, Zenati M, Abu-Hamad G, Rhee RY, Makaroun MS, et al. Contemporary results of open repair of ruptured descending thoracic and thoracoabdominal aortic aneurysms. J Vasc Surg. 2007;45:667–676
  16. Crawford ES, Hess KR, Cohen ES, Coselli JS, Safi HJ. Ruptured aneurysm of the descending thoracic and thoracoabdominal aorta (Analysis according to size and treatment). Ann Surg. 1991;213:417–425discussion 425-6
  17. Melissano G, Bertoglio L, Kahlberg A, Baccellieri D, Marrocco-Trischitta MM, Calliari F, et al. Evaluation of a new disease-specific endovascular device for type B aortic dissection. J Thorac Cardiovasc Surg. 2008;136:1012–1018
  18. Trimarchi S, Nienaber CA, Rampoldi V, Myrmel T, Suzuki T, Bossone E, et al. Role and results of surgery in acute type B aortic dissection: insights from the International Registry of Acute Aortic Dissection (IRAD). Circulation. 2006;114(1 Suppl):I357–I364
  19. Fattori R, Tsai TT, Myrmel T, Evangelista A, Cooper JV, Trimarchi S, et al. Complicated acute type B dissection: is surgery still the best option? (A report from the international registry of acute aortic dissection). JACC Cardiovasc Interv. 2008;1:395–402
  20. Tang GL, Tehrani HY, Usman A, Katariya K, Otero C, Perez E, et al. Reduced mortality, paraplegia, and stroke with stent graft repair of blunt aortic transections: a modern meta-analysis. J Vasc Surg. 2008;47:671–675
  21. Schermerhorn ML, Giles KA, Hamdan AD, Dalhberg SE, Hagberg R, Pomposelli F. Population-based outcomes of open descending thoracic aortic aneurysm repair. J Vasc Surg. 2008;48:821–827
  22. Rigberg DA, McGory ML, Zingmond DS, Maggard MA, Agustin M, Lawrence PF, et al. Thirty-day mortality statistics underestimate the risk of repair of thoracoabdominal aortic aneurysms: a statewide experience. J Vasc Surg. 2006;43:217–222discussion 223
  23. Takagi H, Kawai N, Umemoto T. A meta-analysis of comparative studies of endovascular versus open repair for blunt thoracic aortic injury. J Thorac Cardiovasc Surg. 2008;135:1392–1394
  24. Xenos ES, Abedi NN, Davenport DL, Minion DJ, Hamdallah O, Sorial EE, et al. Meta-analysis of endovascular vs open repair for traumatic descending thoracic aortic rupture. J Vasc Surg. 2008;48:1343–1351
  25. Neschis DG, Scalea TM, Flinn WR, Griffith BP. Blunt aortic injury. N Engl J Med. 2008;359:1708–1716
  26. Akins CW, Buckley MJ, Daggett W, McIlduff JB, Austen WG. Acute traumatic disruption of the thoracic aorta: a ten-year experience. Ann Thorac Surg. 1981;31:305–309
  27. Buth J, Harris PL, Hobo R, van Eps R, Cuypers P, Duijm L, et al. Neurologic complications associated with endovascular repair of thoracic aortic pathology: incidence and risk factors (a study from the European Collaborators on Stent/Graft Techniques for Aortic Aneurysm Repair (EUROSTAR) registry). J Vasc Surg. 2007;46:1103–1110discussion 1110-1
  28. van Prehn J, van Herwaarden JA, Muhs BE, Arnofsky A, Moll FL, Verhagen HJ. Difficulties with endograft sizing in a patient with traumatic rupture of the thoracic aorta: the possible influence of hypovolemic shock. J Vasc Surg. 2008;47:1333–1336
  29. Glower DD, Fann JI, Speier RH, Morrison L, White WD, Smith LR, et al. Comparison of medical and surgical therapy for uncomplicated descending aortic dissection. Circulation. 1990;82(5 Suppl):IV39–IV46
  30. Cambria RP, Brewster DC, Gertler J, Moncure AC, Gusberg R, Tilson MD, et al. Vascular complications associated with spontaneous aortic dissection. J Vasc Surg. 1988;7:199–209
  31. Bossone E, Rampoldi V, Nienaber CA, Trimarchi S, Ballotta A, Cooper JV, et al. Usefulness of pulse deficit to predict in-hospital complications and mortality in patients with acute type A aortic dissection. Am J Cardiol. 2002;89:851–855
  32. Suzuki T, Mehta RH, Ince H, Nagai R, Sakomura Y, Weber F, et al. Clinical profiles and outcomes of acute type B aortic dissection in the current era: lessons from the International Registry of Aortic Dissection (IRAD). Circulation. 2003;108(Suppl 1):II312–II317
  33. Hagan PG, Nienaber CA, Isselbacher EM, Bruckman D, Karavite DJ, Russman PL, et al. The International Registry of Acute Aortic Dissection (IRAD): new insights into an old disease. JAMA. 2000;283:897–903
  34. Elefteriades JA, Lovoulos CJ, Coady MA, Tellides G, Kopf GS, Rizzo JA. Management of descending aortic dissection. Ann Thorac Surg. 1999;67:2002–2005discussion 2014-9
  35. Lauterbach SR, Cambria RP, Brewster DC, Gertler JP, Lamuraglia GM, Isselbacher EM, et al. Contemporary management of aortic branch compromise resulting from acute aortic dissection. J Vasc Surg. 2001;33:1185–1192
  36. Slonim SM, Miller DC, Mitchell RS, Semba CP, Razavi MK, Dake MD. Percutaneous balloon fenestration and stenting for life-threatening ischemic complications in patients with acute aortic dissection. J Thorac Cardiovasc Surg. 1999;117:1118–1126
  37. Barnes DM, Williams DM, Dasika NL, Patel HJ, Weder AB, Stanley JC, et al. A single-center experience treating renal malperfusion after aortic dissection with central aortic fenestration and renal artery stenting. J Vasc Surg. 2008;47:903–910discussion 910-1
  38. Dake MD, Kato N, Mitchell RS, Semba CP, Razavi MK, Shimono T, et al. Endovascular stent-graft placement for the treatment of acute aortic dissection. N Engl J Med. 1999;340:1546–1552
  39. Feezor RJ, Martin TD, Beaver TM, Kledell CT, Lee A. Early outcomes after endovascular management of acute, complicated type B aortic dissection. Jr. PJH J Vasc Surg. 2009;49:561–566discussion 566-7
  40. Verhoye JP, Miller DC, Sze D, Dake MD, Mitchell RS. Complicated acute type B aortic dissection: midterm results of emergency endovascular stent-grafting. J Thorac Cardiovasc Surg. 2008;136:424–430
  41. Hata M, Shiono M, Inoue T, Sezai A, Niino T, Negishi N, et al. Optimal treatment of type B acute aortic dissection: long-term medical follow-up results. Ann Thorac Surg. 2003;75:1781–1784
  42. Bernard Y, Zimmermann H, Chocron S, Litzler JF, Kastler B, Etievent JP, et al. False lumen patency as a predictor of late outcome in aortic dissection. Am J Cardiol. 2001;87:1378–1382
  43. Rodriguez JA, Olsen DM, Lucas L, Wheatley G, Ramaiah V, Diethrich EB. Aortic remodeling after endografting of thoracoabdominal aortic dissection. J Vasc Surg. 2008;47:1188–1194
  44. Moore R, Nutley M, Cina CS, Motamedi M, Faris P, Abuznadah W. Improved survival after introduction of an emergency endovascular therapy protocol for ruptured abdominal aortic aneurysms. J Vasc Surg. 2007;45:443–450
  45. Sadat U, Boyle JR, Walsh SR, Tang T, Varty K, Hayes PD. Endovascular vs open repair of acute abdominal aortic aneurysms--a systematic review and meta-analysis. J Vasc Surg. 2008;48:227–236
  46. Mehta M, Clement Darling I, Paty PSK, Roddy SP, Taggert JB, Sternbach Y, et al. Endovascular vs. open repair of ruptured thoracic aortic aneurysms: mid-term outcomes of a prospective intent-to-treat study. R 2008;Society of Vascular Surgery Annual Meeting; 2008; San Diego, CA
  47. Patel HJ, Williams DM, Upchurch GR, Deeb M. A 15 year comparative analysis of open and endovascular repair for the ruptured descending thoracic aorta. 2009;Society for Clinical Vascular Surgery; 2009; Ft. Lauderdale, Fl.

 Competition of interest: Joseph Bavaria is a primary investigator for WL Gore and is on their speaker's bureau. Richard Cambria has received research support to conduct this trial, and as principle investigator has received intermittent consulting fees. The study was funded by W.L. Gore Company. Mark Farber has been paid a consulting fee by Medtronic, WL Gore, Book, and Bolton Medical. Christopher Kwolek is a consultant for Medtronic and is on the speaker's bureau for Cook Medical.

 Additional material for this article may be found online at www.jvascsurg.org.

 The editors and reviewers of this article have no relevant financial relationships to disclose per the JVS policy that requires reviewers to decline review of any manuscript for which they may have a competition of interest.

PII: S0741-5214(09)01575-4

doi: 10.1016/j.jvs.2009.07.104

Journal of Vascular Surgery
Volume 50, Issue 6 , Pages 1255-1264.e4 , December 2009

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