Minimally Invasive Endovascular Repair for Nondissected Ascending Aortic Disease: A Systematic Review

Huo, Weixue; He, Mengwei; Bao, Xianhao; Lu, Ye; Tian, Wen; Feng, Jiaxuan; Zeng, Zhaoxiang; Feng, Rui

doi:https://doi.org/10.1155/2023/5592622

Emergency Medicine International

On this page

Abstract Introduction Methods Results Discussion Conclusion Data Availability Conflicts of Interest Authors’ Contributions Acknowledgments References Copyright Related Articles

Review Article | Open Access

Volume 2023 | Article ID 5592622 | https://doi.org/10.1155/2023/5592622

Minimally Invasive Endovascular Repair for Nondissected Ascending Aortic Disease: A Systematic Review

Weixue Huo,¹Mengwei He,¹Xianhao Bao,¹Ye Lu,¹Wen Tian,¹Jiaxuan Feng,^1,2Zhaoxiang Zeng ,²and Rui Feng¹

Academic Editor: Roberto Cirocchi

Received18 Jun 2023

Revised03 Aug 2023

Accepted05 Sept 2023

Published19 Sept 2023

Abstract

Objective. The aim of this study is to evaluate the efficacy of endovascular treatment for nondissected diseases of the ascending aorta. Data Sources. PubMed, Embase, and SciELO. Review Methods. In this study, we conducted a search on the PubMed, Embase, and SciELO databases for all cases of ascending aortic endovascular repair included in the literature published between January 2007 and July 2023, excluding type A aortic dissection. We reviewed 56 case reports and 7 observational studies included in this study, assessing the techniques, equipment, procedural steps, and results. We summarized the age, complications, follow-up time, and access route. Results. This study includes 63 articles reporting 105 patients (mean age: 64.96 ± 17.08 years) who received endovascular repair for nondissected ascending aortic disease. The types of disease include aneurysm (N = 16), pseudoaneurysm (N = 71), penetrating aortic ulcer (N = 10), intramural hematoma (N = 2), thrombosis (N = 2), iatrogenic coarctation (N = 1), and rupture of the aorta (N = 3). The success rate of surgery is 99.05% (104/105). Complications include endoleak (10.48%, 11/105), stroke (5.71%, 6/105), postoperative infection (1.91%, 2/105), acute renal failure (0.95%, 1/105), aortic rupture (0.95%, 1/105), thrombosis (0.95%, 1/105), and splenic infarction (0.95%, 1/105). Five patients required conversion to open surgery, two patients underwent endovascular reintervention, and four of these five patients underwent surgery due to endoleak. Early mortality was 2.86% (3/105). Conclusion. While the viability and results of endovascular repair for the treatment of ascending aortic disease are acknowledged in some circumstances, further research is needed to determine the safety and effectiveness of endovascular treatment for ascending aortic disease.

1. Introduction

Ascending aortic disease encompasses a spectrum of conditions, such as true aneurysm, pseudoaneurysm, intramural hematoma, and penetrating ulcer. These diseases are capable of causing severe morbidity and mortality and thus necessitate timely and appropriate conservative or surgical management. In the current clinical landscape, open surgical repair remains the gold standard intervention for mitigating the progression of these conditions and preserving the wellbeing of affected individuals.

Standard surgical treatment has good outcomes and low mortality. However, the presence of intraoperative adhesions and possible severe bleeding during sternostomy may complicate the surgical procedure and increase the risk of death [1]. As a result, complications and mortality from open surgery remain high in elderly patients with severe comorbidities or those with a history of cardiovascular surgery [2].

In a recent report on the treatment of ascending aortic pseudoaneurysm, the in-hospital mortality rate corrected by surgical ranged from 6.7% to 41%, while the survival rates at 1, 5, and 10 years after surgery were 94%, 79%, and 68%, respectively [3]. Elderly patients, inefficiency of chronic kidney disease, and previous cardiac surgery are independent predictors of increased early mortality.

Endovascular repair is a possible alternative therapy for aortic disease with fewer side effects. In addition, this method has been applied in a single or many case reports to treat nondissected ascending aortic disease.

Published reports over the past 20 years have demonstrated that the use of covered stent grafts to treat ascending aortic disease is a potentially life-saving treatment option, giving the clinical situation time to settle and enabling more precise treatment planning.

Endovascular repair has been successfully used in some ascending aortic diseases such as ascending aortic pseudoaneurysm [4] and aortic penetrating ulcer [5].

For nondissected ascending aortic disease (ascending aortic aneurysm, pseudoaneurysm, penetrating aneurysm, penetrating ulceration, and rupture), we evaluated the current condition of endovascular repair in this study.

2. Methods

We conduct a search of PubMed using the following medical terms: “endovascular repair” limited to the “ascending aorta” location. Similarly, we search for terms such as “endovascular repair,” “endovascular stent grafting,” “covered stent repair,” “endovascular stent placement,” and “transcatheter covered stent delivery” limited to the “ascending aorta.” The search was limited to English-language literature from the first week of January 2007 to the first week of July 2023.

We screen studies using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) tool for critical appraisal and summarize them based on the number of participants, methods, technical interventions, and outcomes. Two independent reviewers evaluate the potentially relevant citations identified for inclusion. For the identified literature, we first perform preliminary screening based on the title and abstract. If the relevance cannot be determined, we will assess the full text for eligibility. Any discrepancies between the two reviewers were resolved through consensus.

We collect information on the included endovascular repairs and summarized them in a table, highlighting demographic characteristics, past surgical history, intervention measures, and results.

2.1. Inclusion Criteria

As the initial search criteria, we choose “endovascular treatment of nondissected ascending aortic diseases.” Literatures in any language are considered, hybrid surgery, and open surgery are not included, and endovascular therapy is used in all the cases. The studies included are required to report patients’ baseline health status, surgical history, postoperative complications, mortality data, the treatment method used, technical configurations of endovascular treatment, as well as other necessary follow-up and patient information.

2.2. Exclusion Criteria

In terms of treatment modality, articles or case reports that do not involve endovascular treatment are excluded. In addition, the endovascular treatment device is limited to covered stents, while other types of devices such as occluders and coil embolization devices are excluded. In terms of disease types, articles or case reports related to aortic dissection of the ascending aorta are excluded.

2.3. Data Extraction

After carefully reviewing the collected reviews or case reports, the data on aortic disease, age, gender, underlying diseases, number of cases, stent implantation type, access, follow-up, complications, mortality, causes of death, and reoperation were compiled. Continuous data such as the mean ± standard deviation are also included, and dichotomous variables are expressed as percentages.

3. Results

Figure 1 illustrates the study flowchart from the initial search of the published literature to the final inclusion or exclusion of studies. Using the search strategy outlined above, a total of 4239 articles were initially retrieved, of which 3818 were excluded based on predefined filters. Further exclusion of 217 articles is conducted based on their abstracts and titles. Among the remaining 204 articles, a full-text review was performed, resulting in a final selection of 56 case reports and 7 observational studied, for a total of 63 studies [1, 6–67]. All studies are retrospective and covered the period from January 2007 to July 2023, with a total of 105 patients described. The average age of the patients is 64.96 ± 17.08 years (range: 10–91 years), with 63 males and 41 females in the cohort. Gender is not reported in one case report, and follow-up outcome data are not reported in eight cases, accounting for a total of nine patients. The average follow-up time for the remaining 96 patients is 8.92 months. The detailed information of 105 patients in this article is shown in Table 1.

3.1. Indications for Ascending Aortic Endovascular Repair

Patients with aneurysms, pseudoaneurysms, penetrating aortic ulcers, intramural haematomas confined to the ascending aorta, thrombosis, iatrogenic coarctation, and aortic rupture are included in this analysis. As shown in Figure 2, the composition of each type of ascending aortic disease in this analysis is as follows: pseudoaneurysm (71 cases, 68%), aortic aneurysm (16 cases, 15%), penetrating ulcer (10 cases, 9%), aortic rupture (3 cases, 3%), thrombosis (2 cases, 2%), intramural hematoma (2 cases, 2%), and iatrogenic aortic coarctation (1 case, 1%). In all cases, aortic disease affects only the aortic segment between the sinus canal junction and the innominate artery (IA) orifice and does not involve the aortic valve and aortic root. As shown in Table 2, the vast majority of patients have a potential illness or related surgical history, so they are assessed as unsuitable for open. All patients with nondissected ascending aortic disease in this study underwent endovascular stent implantation.

3.2. Access

In this study, the composition of the vascular approach includes the following: transfemoral artery (54 patients, 53%), subclavian artery (17 patients, 17%), transapical puncture site route (14 patients, 14%), left carotid artery (6 patients, 6%), right carotid artery (6 patients, 6%), and iliac artery (4 patients, 4%). All details are presented in Figure 3.

3.3. Equipment Selection and Technical Details

In addition to 3 reports that did not report the number of stents used, a total of 128 stents were used in this study, including 94 off-the-shelf stents, 20 customized stents, and 14 physician-modified stents. The average length of the stent is 74.72 ± 35.01 mm (range: 28.5–200 mm) and the average diameter is 37.16 ± 5.73 mm (range: 22−48 mm).

Of the 87 cases in which the location of the covered stent is reported, 75.9% (66 cases) of the covered stents are located proximal to the coronary artery and distal to the innominate artery. Of the composition of the distal position of the stent, 11.5% (10 cases) are located distal to the left subclavian artery, 5.7% (5 cases) covered the innominate artery, and 3.4% (3 cases) covered the left common carotid artery. And of these 17 cases, uninnominate artery stenting and left carotid stenting are also performed. It is worth mentioning that 2 patients underwent endo-Bentall surgery, which combines the repair of the aortic valve, and the proximal end of the stent is located near the coronary artery. More detailed information on the endovascular implants used is shown in Table 3.

4. Clinical Outcomes

As shown in Table 4, 21.9% (23/105) experience complications, including endoleak (11 cases), stroke (6 cases), postoperative infection (2 case), acute renal failure (1 case), aortic rupture (1 case), and thrombosis (1 case), splenic infarction (1 case) and 1 patient who needed to switch to open surgery. Two patients underwent endovascular reintervention and other 5 patients underwent surgery again due to endoleak.

The overall in-hospital mortality rate is 2.91% (3/105). One patient with pseudoaneurysm dies of respiratory failure and ventricular fibrillation on the 14th postoperative day. A patient with ascending aortic aneurysm develops left ventricular perforation during surgery and undergoes emergency sternotomy to fix the rupture site. But the patient still dies of multiple organ failure 24 hours later. Another patient develops an acute brainstem stroke and dies on day 15 postoperatively, and autopsy confirmed that the stent has not been displaced and the coronary orifice and brachiocephalic artery are unobstructed.

Table 5 describes the basic information of the deceased patients included in this study, including underlying diseases, surgical history, and postoperative complications. Five patients died during the follow-up period; 1 patient with aortic aneurysm died suddenly before 6 months follow-up without autopsy, one patient with a pseudoaneurysm may have died of cardiogenic stroke after stopping anticoagulation at 6 months without autopsy, one patient with aortic rupture died of multidrug-resistant pneumonia 32 days after surgery, and one patient with aortic rupture died suddenly 3 months after surgery, and autopsy determined that the cause of death is hemopericardium caused by a longitudinal tear of 4.0 cm of the ascending aortic curvature. One patient made a decision not to proceed with any further surgery and declined antibiotic therapy and died 7 months after the first endovascular stent graft procedure.

5. Discussion

In 2007, Lin et al. first reported a case of endovascular repair of ascending aortic nondissected disease [39]. Since then, endovascular repair has become a potential alternative for high-risk patients with nondissected ascending aortic disease [28]. In recent years, there have been increasing reports on endovascular treatment for nondissected ascending aortic diseases, but the safety and efficacy of endovascular treatment remain controversial [48]. This article summarizes a total of 105 patients who underwent endovascular repair treatment from January 2007 to July 2023. The success rate of the surgery is 99.05%, the short-term mortality rate is 2.91%, and the probability of postoperative complications is 21.90%. The results suggest that endovascular treatment for nondissected diseases of the ascending aorta is an alternative surgical approach.

6. Access Route

Currently, the femoral artery approach is the main route for endovascular treatment of aortic diseases. Interestingly, in this study, only 53% of the procedures are performed via the femoral artery approach, while 14% are performed via the transapical approach. Some other perspectives suggest that the transapical approach has advantages in treating nondissected ascending aortic diseases [3] despite the greater damage and need for more surgical skills. The advantage of the transapical approach is that it shortens the working distance [5], which solves the problem of inadequate length of the delivery system caused by the lack of specialized ascending aortic instruments, allowing the operator to significantly improve the manipulation of instruments and achieve more accurate landing. In addition, the transapical approach avoids the more dangerous “over-the-arch operation” and the potential risk of damaging the aortic arch branches [3, 5, 68].

6.1. Complications

In the treatment of nondissected ascending aortic disease, endoleak is the most common complication. The incidence of endoleak in this study report is 10.6%, including type Ia, Ib, and III. Fortunately, most endoleak are small volumes and can be treated conservatively. However, persistent endoleak, especially type I endoleak, may lead to reintervention. To maximize the proximal and distal anchoring zone and prevent endoleak, a careful preoperative examination should be done before choosing the right stent graft configuration [69]. During the postoperative follow-up stage, attention should be paid to CTA examination, timely detection, and evaluation of secondary endoleak, and treatment should be carried out [70]. In addition, stroke is also one of the common complications. In this study, its incidence rate is 5.82%. Older age, severe atherosclerosis, insufficient anticoagulation, intraoperative embolization, and left vertebral artery perfusion loss may be the important causes of stroke in patients undergoing endoaortic repair [71].

6.2. Devices

The design of covered stents for treating ascending aortic diseases is primarily intended for treating diseases in the descending aorta [72]. Their geometric structure is not suitable for ascending aorta. This is because the ascending aorta and aortic arch are more curved, and some patients have a conical ascending aorta, which can easily lead to endoleak and complications. Furthermore, it is worth noting that the length of the anchor zone during endovascular repair of ascending aortic disease is not clearly determined. Based on the existing descending thoracic aortic endovascular repair instruction for use (IFU), it is inferred that the proximal and distal anchorage areas of the covered stent are at least 20 mm while ensuring blood supply to the coronary artery and aortic arch branches. However, considering the short length of the ascending aorta, the anatomical differences in the distance between the sinotubular junction and the brachiocephalic artery’s level of coronary artery opening, and possible accompanying aortic valve disease, this poses a significant challenge to endovascular repair [73].

In addition, the ascending aorta has a larger curvature, and the curvature on both sides of the aorta is uneven. Simple straight covered stents are only suitable for one-third of the patients, making the design of endovascular devices for the ascending aorta challenging. The recently developed Gore ascending covered stent, whose feasibility is undergoing preliminary testing in the ARISE trial, has special features that allow the covered stent to shorten its internal curvature to avoid beak-shaped bending and better adhere to the inner and outer aortic walls. As of July 2023, the results of the ARISE study are still pending (NCT02380716) [68].

So far, the vast majority of endovascular treatment cases for ascending aortic diseases have reported isolated ascending aortic lesions (not involving the aortic valve and root), located between the sinotubular junction and the origin of the brachiocephalic artery, and treated using existing endovascular implantation techniques.

In recent years, an advanced technique called endo-Bentall has been put into clinical practice. In a review published in 2018, Dr. Kreibich proposed endo-Bentall, a new technique for addressing root and proximal ascending aortic lesions [74]. In 2020, Dr. Feng and his colleagues had overcome many difficulties and verified this technique in animals. Animal experiments revealed that this technology might treat proximal ascending aorta diseases related to aortic valve damage [75].

At the same year Felipe Gaia published the first human experience with “endo-Bentall,” using valve fixation via catheterization on an ascending layered stent. In that same year, José Honório Palma and others successfully treated a 64-year-old female patient with endo-Bentall technology who had both an ascending aortic false aneurysm and aortic disease. After a 9-month follow-up, the patient was in good general condition and had no myocardial infarction. The endo-Bentall technique involves using an aortic valve stent implantation procedure to treat aortic lesions involving the valve. It has the following characteristics: an aortic valve ring, a bare area at the sinotubular junction, which is beneficial for reconstructing coronary artery blood flow, and distal anchoring at the ascending aortic level. This new technique provides new opportunities for some patients who cannot be treated by traditional methods. It should be noted that the current technique requires custom-made stents and further research is necessary, as there is no specialized device to bridge the main stent. The long-term patency and durability of the coronary artery are also questionable [76].

6.3. Future Outlook

Compared to the descending thoracic or descending abdominal aorta, the ascending aorta is more complex morphologically and physiologically. Therefore, compared to truncating grafts or employing longer cuffs, the design and production of endovascular repair devices for the ascending aorta is significantly more difficult. The “endo-Bentall” technique, which extends the proximal anchorage region to the aortic root and aortic annulus, presents a solution for valve performance, coronary perfusion, and treatment of ascending aortic disease. However, it should be noted that this technology is not yet fully mature, and further long-term follow-up studies and successful case outcomes are required to support its reliability.

7. Conclusion

In some circumstances, it has been agreed that utilizing covered stents to treat ascending aortic disease is feasible and advantageous, but more research is needed to determine whether this approach is safe and effective. In some high-risk patients with ascending aortic disease, endovascular repair will become more and more common although further research is required. In fact, there is still a need for large clinical trials and technical problems must be solved.

Data Availability

The data in this paper are all from published review or case reports, and the specific information of the paper is given in the references and Table 1.

Conflicts of Interest

The authors declare that they have no conflicts of interest.

Authors’ Contributions

Weixue Huo, Mengwei He, and Xianhao Bao contributed equally to this work.

Acknowledgments

This study was supported by the National Natural Science Foundation of China project (82270505).

References

P. Vallabhajosyula, J. P. Gottret, J. E. Bavaria, N. D. Desai, and W. Y. Szeto, “Endovascular repair of the ascending aorta in patients at high risk for open repair,” The Journal of Thoracic and Cardiovascular Surgery, vol. 149, no. 2, pp. S144–S150, 2015.
View at: Publisher Site | Google Scholar
T. Kunihara, D. Aicher, M. Asano, H. Takahashi, D. Heimann, and F. Sata, “Risk factors for prophylactic proximal aortic replacement in the current era,” Clinical Research in Cardiology, vol. 103, no. 6, pp. 431–440, 2014.
View at: Publisher Site | Google Scholar
H. C. Quevedo and A. Alonso, “Endovascular therapy for ascending aorta pseudoaneurysm,” Cardiovascular Revascularization Medicine, vol. 17, no. 8, pp. 586–588, 2016.
View at: Publisher Site | Google Scholar
H. C. Quevedo, R. Santiago-Trinidad, J. Castellanos, K. Atianzar, A. Anwar, and N. Abi Rafeh, “Systematic review of interventions to repair ascending aortic pseudoaneurysms,” The Ochsner Journal, vol. 14, no. 4, pp. 576–585, 2014.
View at: Google Scholar
C. Wang, E. Regar, M. Lachat, L. K. von Segesser, F. Maisano, and E. Ferrari, “Endovascular treatment of non-dissected ascending aorta disease: a systematic review,” European Journal of Cardio-Thoracic Surgery, vol. 53, no. 2, pp. 317–324, 2018.
View at: Publisher Site | Google Scholar
H. Agrawal, A. Agarwal, C. M. Eichler, and V. S. Mahadevan, “Percutaneous exclusion of a giant ascending aortic pseudoaneurysm,” BMJ Case Reports, vol. 12, no. 7, Article ID e231480, 2019.
View at: Publisher Site | Google Scholar
K. Ahmad, K. Terp, G. Andersen, and V. Hjortdal, “Aortic aneurysms and trans-apical endovascular repair in high risk heart transplant recipient, one year follow up,” Journal of Thoracic Disease, vol. 7, no. 11, pp. E555–E559, 2015.
View at: Publisher Site | Google Scholar
K. B. Allen, J. R. Davis, and D. J. Cohen, “Critical aortic stenosis and acute ascending aortic penetrating ulcer managed utilizing transapical TAVR and TEVAR,” Catheterization and Cardiovascular Interventions, vol. 86, no. 4, pp. 768–772, 2015.
View at: Publisher Site | Google Scholar
A. Almanfi and Z. Krajcer, “Minimally invasive endovascular repair of ascending thoracic aortic aneurysm with use of local anesthesia and conscious sedation,” Texas Heart Institute Journal, vol. 46, no. 2, pp. 120–123, 2019.
View at: Publisher Site | Google Scholar
M. Antonello, A. Spertino, G. Rodino, and G. Tarantini, “Emergent in situ fenestration in the ascending aorta for the endovascular repair of a large pseudoaneurysm: a technical note,” Journal of Endovascular Therapy, vol. 20, Article ID 15266028221125587, 2022.
View at: Publisher Site | Google Scholar
R. Basu, J. Zhang, S. Zaheer, J. Grimm, W. Szeto, and V. Kalapatapu, “Ascending aorta thoracic endovascular aortic repair for infected pseudoaneurysm,” Journal of Vascular Surgery Cases, Innovations and Techniques, vol. 8, no. 2, pp. 244–247, 2022.
View at: Publisher Site | Google Scholar
B. Borrello, D. Carino, A. Agostinelli, A. M. Budillon, and F. J. I. Nicolini, “Primary endovascular repair of the ascending aorta,” Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery, vol. 13, no. 6, pp. 448–450, 2018.
View at: Publisher Site | Google Scholar
J. Chenesseau, P. A. Barral, P. Piquet, and M. Gaudry, “A ruptured penetrating atherosclerotic ulcer of the ascending aorta: a case report of an endovascular repair with extending the length of the aortic coverage by debranching the innominate artery,” European Heart Journal- Case Reports, vol. 3, no. 2, Article ID ytz043, 2019.
View at: Publisher Site | Google Scholar
W. C. Chiang, E. Ling-Lin Pai, P. L. Chen, C. C. Shih, and I. M. Chen, “Endografting under assistance of transapical body floss through-and-through wiring technique and rapid ventricular pacing for an ascending aortic tuberculous pseudoaneurysm,” Annals of Vascular Surgery, vol. 45, pp. 270 e7–e11, 2017.
View at: Publisher Site | Google Scholar
T. L. Engelbert, P. K. Gupta, and J. Matsumura, “Percutaneous thoracic endovascular aortic repair for ascending aortic pseudoaneurysm after prosthetic aortic valve repair,” Journal of Vascular Surgery Cases, vol. 1, no. 4, pp. 283–286, 2015.
View at: Publisher Site | Google Scholar
D. Felipe Gaia, O. Bernal, E. Castilho, C. Baeta Neves Duarte Ferreira, D. Dvir, and M. Simonato, “First-in-Humanendo-bentall procedure for simultaneous treatment of the ascending aorta and aortic valve,” Journal of the American College of Cardiology: Case Reports, vol. 2, no. 3, pp. 480–485, 2020.
View at: Publisher Site | Google Scholar
L. A. Fitzgerald, L. I. El Nihum, P. M. Berens, P. Chinnadurai, Z. Garami, and M. D. Atkins, “Endovascular ascending aortic pseudoaneurysm repair under image fusion guidance and transcranial Doppler monitoring,” Journal of Vascular Surgery Cases, Innovations and Techniques, vol. 8, no. 3, pp. 425–428, 2022.
View at: Publisher Site | Google Scholar
J. A. Gabel, S. T. Patel, R. T. Tomihama, N. W. Hasaniya, A. M. Abou-Zamzam Jr., and S. C. Kiang, “Debranching of supra-aortic vessels via femoral artery inflow for late ascending aortic rupture,” Annals of Vascular Surgery, vol. 57, pp. 49 e1–e5, 2019.
View at: Publisher Site | Google Scholar
T. Gandet, D. Westermann, L. Conradi, G. Panuccio, F. Heidemann, F. Rohlffs et al., “Modular endo-bentall procedure using a “Rendez-Vous access”,” Journal of Endovascular Therapy, vol. 29, no. 5, pp. 711–716, 2022.
View at: Publisher Site | Google Scholar
N. Garg, J. M. Bacharach, and T. R. Reynolds, “Endovascular repair of ascending aortic pseudoaneurysm,” Annals of Vascular Surgery, vol. 25, no. 5, pp. 696 e1–e5, 2011.
View at: Publisher Site | Google Scholar
G. Gelpi, G. Cagnoni, P. Vanelli, and C. Antona, “Endovascular repair of ascending aortic pseudoaneurysm in a high-risk patient,” Interactive Cardiovascular and Thoracic Surgery, vol. 14, no. 4, pp. 494–496, 2012.
View at: Publisher Site | Google Scholar
G. Gerosa, R. Bianco, A. Bortolami, C. D. Lin, P. Frigatti, and G. Tarantini, “Transcatheter repair of combined ascending aortic pseudoaneurysm and aortic arch aneurysm through a cardiac transapical approach,” The Annals of Thoracic Surgery, vol. 92, no. 6, pp. 2259–2262, 2011.
View at: Publisher Site | Google Scholar
S. Gormley, Z. Zaman, K. Mani, and M. Khashram, “Aorto-cutaneous fistula of the ascending aorta-case report and a literature review of endovascular management,” Journal of Vascular Surgery Cases, Innovations and Techniques, vol. 9, no. 1, Article ID 100971, 2023.
View at: Publisher Site | Google Scholar
R. Gottardi, S. Buchholz, Y. Hegazy, and R. Sodian, “Treatment of a massive pseudoaneurysm originating from the ascending aorta with an off-the-shelf stent graft,” European Journal of Cardio-Thoracic Surgery, vol. 60, no. 5, pp. 1234–1236, 2021.
View at: Publisher Site | Google Scholar
B. H. Gray, E. M. Langan, G. Manos, L. Bair, and S. Z. Lysak, “Technical strategy for the endovascular management of ascending aortic pseudoaneurysm,” Annals of Vascular Surgery, vol. 26, no. 5, pp. 734–738, 2012.
View at: Publisher Site | Google Scholar
F. Hanna Quesada, F. Hanna Rodriguez, F. Moroni, A. Marin, J. Nieto, and D. Mejia, “Emergent endovascular repair of a ruptured ascending aorta pseudoaneurysm with thoracic aortic stent graft,” Cardiovascular Revascularization Medicine, vol. 40, pp. 167–169, 2022.
View at: Publisher Site | Google Scholar
E. Howell, M. P. Sweet, and J. D. Pal, “Transapical endovascular repair of an ascending aortic pseudoaneurysm,” Journal of Cardiac Surgery, vol. 31, no. 7, pp. 456–460, 2016.
View at: Publisher Site | Google Scholar
D. L. Joyce, S. K. Singh, H. R. Mallidi, and M. D. Dake, “Endovascular management of pseudoaneurysm formation in the ascending aorta following lung transplantation,” Journal of Endovascular Therapy, vol. 19, no. 1, pp. 52–57, 2012.
View at: Publisher Site | Google Scholar
A. Kahlberg, M. Montorfano, T. Cambiaghi, L. Bertoglio, G. Melissano, and R. Chiesa, “Endovascular stent-grafting of the ascending aorta for symptomatic parietal thrombus,” Journal of Endovascular Therapy, vol. 23, no. 6, pp. 969–972, 2016.
View at: Publisher Site | Google Scholar
M. Khashram, I. Baimatova, A. Laing, J. Blake, and A. Khanafer, “Endovascular repair of a traumatic ascending aortic tear injury,” Journal of Vascular and Interventional Radiology, vol. 27, no. 11, pp. 1712–1714, 2016.
View at: Publisher Site | Google Scholar
A. Khoynezhad, C. E. Donayre, I. Walot, M. C. Koopmann, G. E. Kopchok, and R. A. White, “Feasibility of endovascular repair of ascending aortic pathologies as part of an FDA-approved physician-sponsored investigational device exemption,” Journal of Vascular Surgery, vol. 63, no. 6, pp. 1483–1495, 2016.
View at: Publisher Site | Google Scholar
M. G. Kim, W. C. Kang, P. C. Oh, Y. B. Jeon, J. Y. Lee, and E. K. Shin, “Protective effect of angulated aorta for saving coronary artery during endovascular repair for ascending aortic pseudoaneurysm,” Journal of Thoracic Disease, vol. 8, no. 8, pp. E667–E671, 2016.
View at: Publisher Site | Google Scholar
R. R. Kolvenbach, R. Karmeli, L. S. Pinter, Y. Zhu, F. Lin, and S. Wassiljew, “Endovascular management of ascending aortic pathology,” Journal of Vascular Surgery, vol. 53, no. 5, pp. 1431–1437, 2011.
View at: Publisher Site | Google Scholar
A. P. Kossar, H. Takayama, V. Patel, and I. George, “Novel implementation of a cerebral protection system during ascending thoracic endovascular aortic repair (TEVAR),” Seminars in Thoracic and Cardiovascular Surgery, vol. 31, no. 2, pp. 218–221, 2019.
View at: Publisher Site | Google Scholar
H. Krankenberg, R. Bader, S. Sixt, T. Tübler, C. Schwencke, and D. Kivelitz, “Endovascular repair of ascending aortic aneurysm by transapical approach and periscope technique,” Journal of Endovascular Therapy, vol. 20, no. 1, pp. 13–17, 2013.
View at: Publisher Site | Google Scholar
T. Kratimenos, N. G. Baikoussis, D. Tomais, and M. Argiriou, “Ascending aorta endovascular repair of a symptomatic penetrating atherosclerotic ulcer with a custom-made endograft,” Annals of Vascular Surgery, vol. 47, pp. 280 e1–e4, 2018.
View at: Publisher Site | Google Scholar
D. Kuhelj, C. Langel, M. Bunc, and J. Ksela, “Abdominal stent-graft treatment of ascending aortic pseudoaneurysm following transcatheter aortic valve implantation,” Medicina, vol. 59, no. 1, p. 16, 2022.
View at: Publisher Site | Google Scholar
N. Kus, J. A. Robinson, M. R. Hall, M. Ghoreishi, B. Taylor, and S. Toursavadkohi, “Emergent total endovascular arch repair for contained aortic arch rupture: another tool in the box,” Vascular and Endovascular Surgery, vol. 14, Article ID 15385744231170919, 2023.
View at: Publisher Site | Google Scholar
P. H. Lin, P. Kougias, T. T. Huynh, J. Huh, and J. S. Coselli, “Endovascular repair of ascending aortic pseudoaneurysm: technical considerations of a common carotid artery approach using the Zenith aortic cuff endograft,” Journal of Endovascular Therapy, vol. 14, no. 6, pp. 794–798, 2007.
View at: Publisher Site | Google Scholar
M. Martin Pedrosa, N. C. Revuelta, V. G. Alonso, J. A. Gonzalez Fajardo, and C. Vaquero Puerta, “Endovascular therapy of ascending thoracic aorta,” Annals of Vascular Surgery, vol. 24, no. 5, pp. 696–698, 2010.
View at: Publisher Site | Google Scholar
J. K. Millar, I. Sultan, M. Back, T. D. Martin, T. M. Beaver, and G. J. Arnaoutakis, “Trans-carotid endovascular repair of ascending aortic pseudoaneurysms,” Journal of Cardiac Surgery, vol. 34, no. 1, pp. 28–30, 2019.
View at: Publisher Site | Google Scholar
J. M. Moriarty, R. Shah, A. N. Hage, R. N. Srinivasa, and J. A. Aboulhosn, “Back-table modified aortic endograft deployed via “innominate bounce” technique for management of a zone 0 ascending aortic pseudoaneurysm,” Annals of Vascular Surgery, vol. 59, pp. 307 e1–e5, 2019.
View at: Publisher Site | Google Scholar
F. F. Mussa, S. A. LeMaire, J. Bozinovski, and J. S. Coselli, “An entirely endovascular approach to the repair of an ascending aortic pseudoaneurysm,” The Journal of Thoracic and Cardiovascular Surgery, vol. 133, no. 2, pp. 562-563, 2007.
View at: Publisher Site | Google Scholar
F. J. H. Nauta, K. D. Lau, C. J. Arthurs, K. A. Eagle, D. M. Williams, and S. Trimarchi, “Computational fluid dynamics and aortic thrombus formation following thoracic endovascular aortic repair,” The Annals of Thoracic Surgery, vol. 103, no. 6, pp. 1914–1921, 2017.
View at: Publisher Site | Google Scholar
G. S. Oderich, A. Pochettino, B. C. Mendes, B. Roeder, J. Pulido, and P. Gloviczki, “Endovascular repair of saccular ascending aortic aneurysm after orthotopic heart transplantation using an investigational zenith ascend stent-graft,” Journal of Endovascular Therapy, vol. 22, no. 4, pp. 650–654, 2015.
View at: Publisher Site | Google Scholar
G. Piffaretti, M. Cottini, G. Carrafiello, P. Castelli, C. Beghi, and G. Mariscalco, “Endovascular repair of ascending aortic pseudoaneurysm with custom-designed endograft,” The Annals of Thoracic Surgery, vol. 100, no. 2, pp. e31–e33, 2015.
View at: Publisher Site | Google Scholar
G. Piffaretti, M. Galli, C. Lomazzi, M. Franchin, P. Castelli, and G. Mariscalco, “Endograft repair for pseudoaneurysms and penetrating ulcers of the ascending aorta,” The Journal of Thoracic and Cardiovascular Surgery, vol. 151, no. 6, pp. 1606–1614, 2016.
View at: Publisher Site | Google Scholar
O. Preventza, M. J. Henry, B. Y. Cheong, and J. S. Coselli, “Endovascular repair of the ascending aorta: when and how to implement the current technology,” The Annals of Thoracic Surgery, vol. 97, no. 5, pp. 1555–1560, 2014.
View at: Publisher Site | Google Scholar
F. P. Rorris, P. Tsipas, T. Kratimenos, and J. Kokotsakis, “Failure of endovascular repair in the ascending aorta,” The Annals of Thoracic Surgery, vol. 110, no. 3, p. e245, 2020.
View at: Publisher Site | Google Scholar
E. E. Roselli, J. Idrees, R. K. Greenberg, D. R. Johnston, and B. W. Lytle, “Endovascular stent grafting for ascending aorta repair in high-risk patients,” The Journal of Thoracic and Cardiovascular Surgery, vol. 149, no. 1, pp. 144–154, 2015.
View at: Publisher Site | Google Scholar
L. Ryan, D. T. Collins, and D. Mukherjee, “A first time repair of pseudoaneurysm of the ascending aorta with a Valiant Navion Evo thoracic endograft®,” Cardiovascular Revascularization Medicine, vol. 19, no. 8, pp. 31–34, 2018.
View at: Publisher Site | Google Scholar
E. K. Saadi, L. Moura, A. Zago, and A. Zago, “Endovascular repair of ascending aorta and coronary stent implantation,” Revista Brasileira de Cirurgia Cardiovascular, vol. 26, no. 3, pp. 477–480, 2011.
View at: Publisher Site | Google Scholar
T. Sakata, H. Ueda, M. Watanabe, H. Kohno, Y. Tamura, and S. Abe, “Endovascular treatment for proximal anastomotic pseudoaneurysm after total arch replacement in behcet's disease,” Annals of Vascular Surgery, vol. 34, pp. 272.e9–272.e12, 2016.
View at: Publisher Site | Google Scholar
N. U. Saqib, H. M. Ray, Z. Al Rstum, K. L. Rommens, H. J. Safi, and A. L. Estrera, “Endovascular repair of ruptured ascending aorta secondary to embolized transcatheter aortic valve,” The Annals of Thoracic Surgery, vol. 109, no. 3, pp. e187–e189, 2020.
View at: Publisher Site | Google Scholar
K. Shaikhrezai, P. Nanjaiah, S. M. Ingram, and E. T. Brackenbury, “Staged hybrid treatment of ascending aorta aneurysm post cardiac surgery,” Interactive Cardiovascular and Thoracic Surgery, vol. 16, no. 6, pp. 917–919, 2013.
View at: Publisher Site | Google Scholar
C. C. Shults, E. P. Chen, V. H. Thourani, and B. G. Leshnower, “Transapical thoracic endovascular aortic repair as a bridge to open repair of an infected ascending aortic pseudoaneurysm,” The Annals of Thoracic Surgery, vol. 100, no. 5, pp. 1883–1886, 2015.
View at: Publisher Site | Google Scholar
A. Skrabonja-Crespo, F. Chavarri-Velarde, M. Pinto-Salinas, and A. Tauma-Arrue, “Percutaneous endovascular management of ascending aortic pseudoaneurysm after heart transplantation in a pediatric patient,” Pediatric Transplantation, vol. 25, no. 3, Article ID e13958, 2021.
View at: Publisher Site | Google Scholar
W. Y. Szeto, W. G. Moser, N. D. Desai, R. K. Milewski, A. T. Cheung, and A. Pochettino, “Transapical deployment of endovascular thoracic aortic stent graft for an ascending aortic pseudoaneurysm,” The Annals of Thoracic Surgery, vol. 89, no. 2, pp. 616–618, 2010.
View at: Publisher Site | Google Scholar
S. Takago, H. Kato, Y. Yamamoto, K. Iino, K. Kimura, and H. Takemura, “Thoracic endovascular aortic repair for an ascending aortic pseudoaneurysm,” Asian Cardiovascular & Thoracic Annals, vol. 28, no. 6, pp. 330–332, 2020.
View at: Publisher Site | Google Scholar
K. Uchida, K. Imoto, H. Yanagi, D. Machida, M. Okiyama, and S. Yasuda, “Endovascular repair of ascending aortic rupture: effectiveness of a fenestrated stent-graft,” Journal of Endovascular Therapy, vol. 17, no. 3, pp. 395–398, 2010.
View at: Publisher Site | Google Scholar
T. M. J. van Bakel, N. S. Burris, H. J. Patel, and C. A. Figueroa, “Ascending aortic rupture after zone 2 endovascular repair: a multiparametric computational analysis,” European Journal of Cardio-Thoracic Surgery, vol. 56, no. 3, pp. 618–621, 2019.
View at: Publisher Site | Google Scholar
E. Vaughan-Huxley, M. S. Hamady, M. J. Metcalfe, B. Adams, E. Kashef, and N. J. Cheshire, “Endovascular repair of an acute, mycotic, ascending aortic pseudoaneurysm,” European Journal of Vascular and Endovascular Surgery, vol. 41, no. 4, pp. 488–491, 2011.
View at: Publisher Site | Google Scholar
P. Veroux, G. D'Arrigo, A. Giaquinta, C. Virgilio, A. Cappellani, and M. Veroux, “Emergency endovascular repair of two ascending aortic pseudoaneurysms,” Journal of Vascular and Interventional Radiology, vol. 22, no. 3, pp. 417–419, 2011.
View at: Publisher Site | Google Scholar
K. Wada, T. Shimamoto, T. Komiya, and H. Tsuneyoshi, “Physician modification to shorten a TAG thoracic endoprosthesis for treatment of a pseudoaneurysm in the ascending aorta,” Journal of Endovascular Therapy, vol. 23, no. 3, pp. 489–492, 2016.
View at: Publisher Site | Google Scholar
S. Yerram, A. Vikrama, S. Mahapatra, S. Bhyravavajhala, and R. Venkata Kumar, “Post-operative recurrent ascending aortic pseudoaneurysm with aorto-cutaneous fistula- endovascular management with an in-situ stent-graft fenestration for the innominate artery,” Annals of Vascular Surgery, vol. 75, pp. 534.e5–534.e9, 2021.
View at: Publisher Site | Google Scholar
K. Yuri, A. Yamaguchi, D. Hori, K. Nemoto, S. Kawaguchi, and Y. Yokoi, “A fenestrated stent graft for endovascular repair of an ascending aortic pseudoaneurysm,” Annals of Vascular Diseases, vol. 3, no. 3, pp. 228–231, 2010.
View at: Publisher Site | Google Scholar
A. C. Zago, E. K. Saadi, and A. J. Zago, “Endovascular approach to treat ascending aortic pseudoaneurysm in a patient with previous CABG and very high surgical risk,” Catheterization and Cardiovascular Interventions, vol. 78, no. 4, pp. 551–557, 2011.
View at: Publisher Site | Google Scholar
O. Preventza, A. L. Huu, J. Olive, D. Cekmecelioglu, and J. S. Coselli, “Endovascular repair of the ascending aorta: the last Frontier,” Annals of Cardiothoracic Surgery, vol. 11, no. 1, pp. 26–30, 2022.
View at: Publisher Site | Google Scholar
Z. Liu, Y. Zhang, C. Liu, D. Huang, M. Zhang, and F. Ran, “Treatment of serious complications following endovascular aortic repair for type B thoracic aortic dissection,” Journal of International Medical Research, vol. 45, no. 5, pp. 1574–1584, 2017.
View at: Publisher Site | Google Scholar
S. Ameli-Renani, V. Pavlidis, R. A. J. C. Morgan, and I. Radiology, “Secondary endoleak management following tevar and evar,” Cardio Vascular and Interventional Radiology, vol. 43, no. 12, pp. 1839–1854, 2020.
View at: Publisher Site | Google Scholar
M. D'Oria, K. Mani, R. DeMartino, M. Czerny, K. P. Donas, and A. Wanhainen, “Narrative review on endovascular techniques for left subclavian artery revascularization during thoracic endovascular aortic repair and risk factors for postoperative stroke,” Interactive Cardiovascular and Thoracic Surgery, vol. 32, no. 5, pp. 764–772, 2021.
View at: Publisher Site | Google Scholar
M. Boufi and Z. Rancic, “Commentary: stent-graft to treat specific ascending aorta pathology: waiting for the instructions for use,” Journal of Endovascular Therapy, vol. 23, no. 6, pp. 973–975, 2016.
View at: Publisher Site | Google Scholar
D. Kotelis, J. Kalder, and M. J. Jacobs, “Endovascular repair of the ascending aorta: the last Frontier?” Journal of Thoracic Disease, vol. 8, no. 8, pp. E825–E826, 2016.
View at: Publisher Site | Google Scholar
M. Kreibich, B. Rylski, S. Kondov, J. Morlock, J. Scheumann, and F. A. Kari, “Endovascular treatment of acute Type A aortic dissection-the Endo Bentall approach,” The Journal of Visualized Surgery, vol. 4, p. 69, 2018.
View at: Publisher Site | Google Scholar
J. Feng, X. Bao, T. Li, Y. Zhao, M. Wu, and J. Liu, “Endovascular reconstruction from aortic valve to aortic arch using 1-piece valved fenestrated bifurcated endografting,” Journal of the American College of Cardiology, vol. 75, no. 16, pp. 2090–2092, 2020.
View at: Publisher Site | Google Scholar
J. C. Grimm, M. Ibrahim, and W. Y. Szeto, “Endo-Bentall: is this feasible?” Annals of Cardiothoracic Surgery, vol. 11, no. 1, pp. 46-47, 2022.
View at: Publisher Site | Google Scholar

Copyright

Copyright © 2023 Weixue Huo et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

PDF Download Citation

Download other formats

Order printed copies

Views

310

Downloads

359

Citations