Annals of vascular surgery · 2026
Proximal Neck Diameter Changes Following Zone 0 TEVAR With or Without Ascending Aortic Wrapping.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Shijo Takayuki, Shimamura Kazuo, Maeda Koichi, Watanabe Yoshiki, Shirakawa Takashi, Ide Toru, Yamana Fumio, Sakakibara Satoshi, Takahara Mitsuyoshi, Miyagawa Shigeru
Аннотация
BACKGROUND: In zone 0 thoracic endovascular aortic repair (TEVAR), ascending aortic wrapping for a moderately dilated ascending aorta may stabilize the proximal landing zone. This study evaluated serial changes in proximal aortic diameter after zone 0 TEVAR and explored the potential stabilizing effect of ascending aortic wrapping.
METHODS: This retrospective, single-center study included 108 patients with degenerative aortic arch aneurysms who underwent zone 0 TEVAR between 2008 and 2022. Thirty patients received concomitant ascending aortic wrapping (group W) and 78 underwent TEVAR without wrapping (group N). We assessed serial changes in ascending aortic diameter at the proximal neck.
RESULTS: Preoperative proximal neck diameter was larger in group W (median 39 mm [IQR 38-41]) than in group N (34 mm [IQR 32-36]; p < .001), and it decreased to 30 mm [IQR 28-31] after wrapping. In group W, diameter increased significantly during the first postoperative year (2.5 mm/year; 95% CI 1.9-3.0; p < .001), then slowed yet showed a continued upward trend (0.17 mm/year; 95% CI 0.04-0.31; p = .018). In group N, the growth rate was 0.57 mm/year (95% CI 0.21-0.92; p = .002) in year one and 0.42 mm/year (95% CI 0.18-0.67; p = .001) thereafter. At 5 years, cumulative incidence of late type Ia endoleak was 0% in group W versus 14% (95% CI 5-31%) in group N.
CONCLUSIONS: Ascending aortic wrapping during zone 0 TEVAR may attenuate proximal neck enlargement.
METHODS: This retrospective, single-center study included 108 patients with degenerative aortic arch aneurysms who underwent zone 0 TEVAR between 2008 and 2022. Thirty patients received concomitant ascending aortic wrapping (group W) and 78 underwent TEVAR without wrapping (group N). We assessed serial changes in ascending aortic diameter at the proximal neck.
RESULTS: Preoperative proximal neck diameter was larger in group W (median 39 mm [IQR 38-41]) than in group N (34 mm [IQR 32-36]; p < .001), and it decreased to 30 mm [IQR 28-31] after wrapping. In group W, diameter increased significantly during the first postoperative year (2.5 mm/year; 95% CI 1.9-3.0; p < .001), then slowed yet showed a continued upward trend (0.17 mm/year; 95% CI 0.04-0.31; p = .018). In group N, the growth rate was 0.57 mm/year (95% CI 0.21-0.92; p = .002) in year one and 0.42 mm/year (95% CI 0.18-0.67; p = .001) thereafter. At 5 years, cumulative incidence of late type Ia endoleak was 0% in group W versus 14% (95% CI 5-31%) in group N.
CONCLUSIONS: Ascending aortic wrapping during zone 0 TEVAR may attenuate proximal neck enlargement.