Aortic Arch Aneurysm
Conditions
Keywords
Thoracic endovascular aortic repair, Silent cerebral infarction, Stroke, Magnetic resonance imaging, DW-MRI, Aortic arch disease
Brief summary
This is the largest study to evaluate incidence and distribution of silent cerebral infarction (SBI) following endovascular repair for disease of the aortic arch. Also, it is the first cohort to include total endovascular arch repair and devices flushed with carbon dioxide (CO2) to prevent gaseous cerebral embolization.
Detailed description
Introduction. Poor data exist concerning the rate of silent cerebral ischemic events following endovascular treatment of the aortic arch. The objective of this work was to quantify these lesions using the STEP registry. Methods. This multicentre retrospective cohort study included consecutive patients treated with an aortic endoprosthesis deployed in Ishimaru zone 0 to 3 and brain diffusion-weighted magnetic resonance imaging (DW-MRI) within 7 days after the procedure. DW-MRI was performed to identify the location and number of new silent brain infarctions (SBI), microbleeds ans general outcome of the patients.
Interventions
DEVICEEndovascular Arch Procedures
Endovascular Arch Procedures (TEVAR, Branch endografts, Fenestrated endografts)
Sponsors
Fondation Hôpital Saint-Joseph
Universitätsklinikum Hamburg-Eppendorf
Vascular Surgical Research Group, Imperial College, London, UK
Sanger Heart and Vascular Institute, Charlotte, NC
Loyola University Medical Center, Maywood, IL
UAB School of Medicine, Birmingham, AL
Heidelberg University Hospital, Heidelberg, Germany
University Hospital of Freiburg, Freiburg, Germany
Stanford University
Massachusetts General Hospital
Baylor Research Hospital, Dallas, TX
Emory University Hospital, Atlanta, GA
University Hospital of Mainz, Mainz, Germany
Diakonie Hospital Jung-Stilling, Siegen, Germany
Mayo Clinic, Rochester, MN
Sentara Vascular/Eastern Virginia Medical School, Norfolk, VA
Maastricht University Medical Centre, Maastricht, Netherlands
I.R.C.C.S. Policlinico San Donato, San Donato Milanese, Italy
Memorial Care Long Beach Heart & Vascular Institute, Long Beach, CA
Medical University of Vienna
Study design
Observational model
COHORT
Time perspective
OTHER
Eligibility
Sex/Gender
ALL
Age
18 Years to 100 Years
Healthy volunteers
No
Inclusion criteria
* Included patients underwent a proximal endograft deployment in Ishimaru zone 0 to 3
Exclusion criteria
* Missing preoperative computed tomography angiography (CTA) scan of the chest and any circumstances that precluded the DW-MRI to be performed in the appropriate time window, such as a medical condition or an MRI contraindication
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| frequency of silent cerebral infarcts on DW-MRI | 7 days | Primary outcomes were the frequency of silent cerebral infarcts on DW-MRI after endovascular arch procedures, and to identify the number, the distribution, and predictors of these lesions. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| perioperative ischemic stroke | 30 days | Secondary outcomes were perioperative ischemic stroke defined as a brain infarction of ischemic etiology which occurs during surgery or within 30 days after surgery, TIA, hemorrhagic stroke, 30-day mortality, spinal cord ischemia, length of stay and discharge disposition. |
Countries
France, Germany
Outcome results
None listed