Impact of Hybrid Operating Rooms on Long-Term Clinical Outcomes Following Fenestrated and Branched Endovascular Aortic Repair

Giovanni Tinelli, Simona Sica, Marie Bonnet, Adrien Hertault, Gian Luca Di Tanna, Aurélia Bianchini, Dominique Fabre, Jonathan Sobocinski, Stéphan Haulon

Risultato della ricerca: Contributo in rivistaArticolo in rivista

Abstract

Purpose: Evaluate the impact of hybrid operating room (HOR) guidance on the long-term clinical outcomes following fenestrated and branched endovascular repair (F-BEVAR) for complex aortic aneurysms. Materials and Methods: Prospectively collected registry data were retrospectively analyzed to compare the procedural, short- and long-term outcomes of consecutive F-BEVAR performed from January 2010 to December 2014 under standard mobile C-arm versus hybrid room guidance in a high-volume aortic center. Results: A total of 262 consecutive patients, including 133 patients treated with a mobile C-arm equipped operating room and 129 with a HOR guidance, were enrolled in this study. Patient radiation exposure and contrast media volume were significantly reduced in the HOR group. Short-term clinical outcomes were improved despite higher case complexity in the HOR group, with no statistical significance. At a median follow-up of 63.3 months (Q1 33.4, Q3 75.9) in the C-arm group, and 44.9 months (Q1 25.1, Q3 53.5, p=0.53) in the HOR group, there was no statistically significant difference in terms of target vessel occlusion and limb occlusion. When the endograft involved 3 or more fenestrations and/or branches (complex F-BEVAR), graft instability (36% vs 25%, p=0.035), reintervention on target vessels (20% vs 11%, p=0.019) and total reintervention rates (24% vs 15%, p=0.032) were significantly reduced in the HOR group. The multivariable Cox regression analysis did not show statistically significant differences for long-term death and aortic-related death between the 2 groups. Conclusion: Our study suggests that better long-term clinical outcomes could be observed when performing complex F-BEVAR in the latest generation HOR.
Lingua originaleEnglish
pagine (da-a)152660282199672-N/A
RivistaJournal of Endovascular Therapy
DOI
Stato di pubblicazionePubblicato - 2021

Keywords

  • BEVAR
  • FEVAR
  • complex aortic treatment
  • cone beam CT
  • endograft instability
  • hybrid room
  • image fusion
  • long-term result
  • personalized medicine
  • reintervention
  • target vessel instability

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