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Updated: Jul 15, 2026
04:56
Modified Octopus Technique for Thoracoabdominal Aortic Aneurysm
Published on: August 1, 2025
Long-term Outcomes of Thoracic Endovascular Aortic Repair Using a Target Aneurysm-Based Approach for Extensive
Kota Shukuzawa1, Takao Ohki1, Masayuki Hara1
1Division of Vascular Surgery, Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan.
Journal of Vascular Surgery
|July 13, 2026
Summary
A target aneurysm (TA)-based approach improves outcomes for chronic type B aortic dissection (cTBAD) endovascular repair. Achieving TA clinical success is linked to better long-term results and fewer reinterventions.
Area of Science:
- Vascular Surgery
- Interventional Cardiology
- Aortic Disease Management
Background:
- Conventional success metrics for endovascular repair of chronic type B aortic dissection (cTBAD) are often inadequate.
- A target aneurysm (TA)-based treatment concept offers a potentially more relevant evaluation framework.
Purpose of the Study:
- To assess the clinical validity of a target aneurysm (TA)-based treatment concept for evaluating endovascular repair in extensive cTBAD.
- To correlate TA-based success with long-term clinical and morphological outcomes.
Main Methods:
- Retrospective analysis of 124 patients undergoing endovascular repair for extensive cTBAD.
- Defined TA technical and clinical success based on false lumen perfusion and exclusion at the TA level.
- Compared TA-based definitions with conventional (CV) success metrics.
- Assessed morphological outcomes, open conversion (OC), aorta-related death (ARD), and reinterventions.
Main Results:
- TA technical success (96.8%) and TA clinical success at 1 month (73.9%) were significantly higher than CV success rates (17.7% and 14.3%).
- Favorable TA morphology (shrinkage/stable diameter) was observed in 84.0% of patients.
- TA clinical success strongly correlated with improved long-term outcomes, including reduced OC, ARD, and reinterventions (P < 0.013).
Conclusions:
- TA clinical success is a strong predictor of favorable long-term outcomes in cTBAD endovascular repair.
- The TA-based treatment concept provides a clinically meaningful framework for assessing procedural success.
- Endovascular repair guided by the TA concept yields good clinical results, potentially avoiding complex open repairs.
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