Target Vessel Cannulation with a Transfemoral Retrograde Approach Equals Antegrade Approach from the Upper Extremity in Complex Aortic Treatment with Off the Shelf Inner Branched Endografts in the Italian Branched Registry of E-nside Endograft (INBREED).
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
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Esposito Davide, Bastianon Martina, Simonte Gioele, Gatta Emanuele, Bertoglio Luca, Gaggiano Andrea, Frigatti Paolo, Piazza Michele, Antonello Michele, Pratesi Giovanni, ItaliaN Branched Registry of E-nside EnDograft (INBREED) Investigators, Pratesi Giovanni, Spinella Giovanni, Esposito Davide, Bastianon Martina, Melani Caterina, Mena Vera Jorge Miguel, Lenti Massimo, Simonte Gioele, Isernia Giacomo, Baccani Luigi, Parlani Gianbattista, Vento Vincenzo, Carbonari Luciano, Gatta Emanuele, Bonardelli Stefano, Grandi Alessandro, Bertoglio Luca, Ferri Michelangelo, Quaglino Simone, Gaggiano Andrea, Frigatti Paolo, Scrivere Paola, Furlan Federico, Antonello Michele, Piazza Michele, Squizzato Francesco, Spezia Matteo, Grego Franco, Tshomba Yamume, Donati Tommaso, Sica Simona, Tinelli Giovanni, Piffaretti Gabriele, Veraldi Gian Franco, Mezzetto Luca, Gennai Stefano, Leone Nicola, Silingardi Roberto, Iacono Gustavo, Turricchia Giorgio Ubaldo, Angiletta Domenico, Maione Massimo, Apostolou Dimitri, Pulli Raffaele, Fargion Aaron, Filippi Federico, De Angelis Filippo, Arici Vittorio, Bozzani Antonio, Luigi Molinari Alessandro Carlo, Rossi Giovanni, Costantini Brancadoro Emidio, Ferraris Matteo, Dorrucci Vittorio, Derone Graziana, Tolva Valerio Stefano, Monzio Compagnoni Nicola, Segramora Vittorio Maria, Deleo Gaetano, Bracale Umberto, Guzzardi Giuseppe, Ferrer Ciro, Giudice Rocco, Sbarigia Enrico, Cuozzo Simone, Gattuso Roberto, Mansour Wassim, Di Marzo Luca, Grimaldi Sabrina, Corona Mario, Chisci Emiliano, Mechelagnoli Stefano, De Donato Gianmarco, Palasciano Giancarlo, Pasqui Edoardo, Candeloro Laura, Ricci Carmelo, Neri Eugenio, Mangialardi Nicola, Orrico Matteo, Ronchey Sonia, Fazzini Stefano, Ippoliti Arnaldo, Discalzi Andrea, Rossato Denis, Vio Elias, Galeazzi Edoardo, Farneti Fabrizio, Volpe Pietro, Massara Mafalda, Milite Domenico, Xodo Andrea
Аннотация
METHODS: This was a national, physician initiated, multicentre, observational study. Data from a registry on patients treated with the E-nside endograft were gathered prospectively. Patients were divided into two groups based on the type of endovascular approach for TV cannulation. The study adhered to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines.
RESULTS: From September 2020 to February 2024, 166 procedures were collected, of which 128 (77.1%) used an antegrade upper extremity approach to TV cannulation, while 38 (22.9%) employed a retrograde femoral approach. There were no statistically significant differences in terms of bridging stent choice (balloon expandable only, 69.4% vs. 73.7%; self expandable only, 12.9% vs. 7.9%; mixed configurations, 17.7% vs. 18.4%; p = .68). The mean operation time ± standard deviation was longer for the retrograde approach (282 ± 90 minutes vs. 313 ± 155 minutes; p = .006), but fluoroscopy time, dose area product, and the volume of contrast injected were similar. Six cases of post-operative stroke were reported in the antegrade group (4.7% vs. 0%; p = .17). The 30 day TV related technical success was 94.5% and 94.7%, respectively, for antegrade and retrograde approaches (p = .96). Mean follow up was 14.4 ± 11.3 months (median 12.5 months). Kaplan-Meier estimates (with 95% confidence interval [CI]) at twelve months revealed similar overall survival (87.7%, 95% CI 81 - 95% vs. 91.1%, 95% CI 82 - 100%; log rank = .009, p = .92). Competing risk analysis revealed similar one year estimates of TV instability and TV related re-intervention between groups both in patient centred and TV centred analyses.
CONCLUSION: A total transfemoral retrograde approach for TV cannulation of inner branches proved to be effective and was not associated with any neurological events.