@article{JTD21829,
author = {Hyun-Chel Joo and Young-Nam Youn and Young-Guk Ko and Donghoon Choi and Jong Yun Won and Do Yun Lee and Kyung-Jong Yoo},
title = {Comparison of open surgical versus hybrid endovascular repair for descending thoracic aortic aneurysms with distal arch involvement},
journal = {Journal of Thoracic Disease},
volume = {10},
number = {6},
year = {2018},
keywords = {},
abstract = {Background: Our aim was to compare the efficacies of conventional open thoracotomy and hybrid endovascular technique in patients with descending thoracic aortic aneurysms involving the distal arch.
Methods: Between January 2005 and December 2015, 125 consecutive patients with descending aneurysms involving distal arch underwent open repair via thoracotomy (n=79) or zone 1/2 hybrid endovascular repair (n=46). Surgeries entailing total arch replacement by elephant trunk technique (with sternotomy) and Zone 0 hybrid arch repairs were excluded. Early and late outcomes were compared using propensity scores and inverse-probability-of-treatment weighting (IPTW).
Results: In-hospital mortality rates for open repair (10.1%) and hybrid repair (6.5%) did not differ significantly (P=0.49). Major adverse outcomes included stroke (11.4% vs. 8.7%), paraplegia (2.5% vs. 0.0%) and lung complications (19.0% vs. 6.5%). Once adjusted by IPTW, hospital mortality risk for conventional open repair (OR =4.396; P=0.086) tended to be higher, and there was significant risk of lung complications (OR =4.372; P=0.025). However, both techniques were similar in terms of 30-day mortality (OR =2.745; P=0.257), stroke (OR =2.134; P=0.217), paraplegia (OR =3.639; P=0.407), and midterm survival (OR =1.05; P=0.90). Freedom from reintervention at 10 years was significantly better for open repair (85.2%±7.1%) compared with the hybrid approach (46.3%±11.0%; OR =0.13; P},
issn = {2077-6624}, url = {https://jtd.amegroups.org/article/view/21829}
}