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Single Stem Visceral Debranching for Complex Aortic Disease

Jean-Michel Davaine1,2, Jérémie Jayet2, Léa Oiknine2

  • 1Sorbonne Université, Faculté de Médecine Campus Pitié-Salpêtrière, Paris, France.

EJVES Vascular Forum
|March 18, 2022
PubMed

Insights

A novel single stem retrograde visceral graft (SSRVG) technique offers a feasible solution for complex aortic diseases, demonstrating high vessel patency and reducing surgical complexity.

Area of Science:

  • Vascular Surgery
  • Aortic Disease Management
  • Minimally Invasive Techniques

Background:

  • Complex aortic diseases, including aortic dissection (AD) and thoraco-abdominal aortic aneurysms (TAAAs), often require intricate surgical reconstructions.
  • Traditional retrograde visceral bypass techniques can be complex, involving multiple graft assemblies.

Purpose of the Study:

  • To present an original single stem retrograde visceral graft (SSRVG) technique for treating complex aortic diseases.
  • To evaluate the feasibility, outcomes, and patency rates of the SSRVG technique.

Main Methods:

  • A retrospective study of 16 patients treated between 2015 and 2019 for AD, TAAAs, or visceral occlusive disease.
  • The SSRVG technique involved visceral vessel debranching from the native infrarenal aorta or an aortic graft, with optional fenestration and thoracic endovascular aneurysm repair (TEVAR).

Main Results:

  • Sixty-nine target vessels were successfully debranched using the SSRVG technique.
  • Postoperative complications included renal insufficiency (44%), pneumonia (25%), and colonic ischemia (19%).
  • After a mean follow-up of 21 months, all debranched vessels remained patent, with no endoleaks observed.

Conclusions:

  • The SSRVG technique is a feasible and effective approach for various complex aortic conditions.
  • This technique simplifies the retroperitoneal reconstruction by utilizing a single graft.
  • High patency rates suggest the long-term viability of the SSRVG for visceral revascularization.
Abstract

Keywords:
Aortic dissectionHybrid surgeryTEVARThoraco-abdominal aortic aneurysmVisceral vessel debranching

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