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Vasc Endovascular Surg. 2010 Aug;44(6):440-5. doi: 10.1177/1538574410371525. Epub 2010 Jun 2.

Thoracic aortic endograft explant: a single-center experience.

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  • 1Department of Vascular Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USA. melissa.kirkwood@uphs.upenn.edu

Abstract

OBJECTIVES:

We report our experience following thoracic aortic endovascular repair (TEVAR) explant.

METHODS:

A total of 500 TEVARs were performed from 1999 to 2009, with 4 requiring explant. Chart review was performed to identify the indications of explant, operative technique, and perioperative morbidity and mortality.

RESULTS:

Indications of graft removal included device maldeployment, type I endoleak, aortoenteric fistula, and retrograde type A dissection necessitating aortic root replacement. Reconstruction was achieved with aortic homograft, Dacron, or explant of the proximal component with incorporation of the distal stent into the suture line. Mean follow-up was 13 months (0-50 months). Paraplegia and perioperative death occurred in 1 patient who underwent intraoperative conversion to open repair. There were no other major complications, and graft removal was achieved in all patients.

CONCLUSIONS:

Although rare, familiarity with TEVAR explant is imperative as it is increasingly performed for broader indications. Our limited data suggest that explant can be performed successfully albeit with morbidity.

PMID:
20519282
[PubMed - indexed for MEDLINE]
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