Innovations in Aortic Repair: Addressing Long-Term Efficacy and Procedural Safety
Szentiványi András Imre
Cardiovascular Medicine and Research Division
Dr. Merkely Béla
SE Városmajori Klinikák Tanterme
2026-01-28 13:30:00
Klinikai és kísérlettes angiológiai kutatások
Csobay-Novák Csaba
Dr. Mihály Zsuzsanna
Dr. Hevér Tímea
Dr. Vágó Hajnalka
Dr. Horváthy Dénes Balázs
Dr. Fazekas Gábor
This thesis comprises three studies addressing critical aspects of aortic intervention, covering both open surgical and endovascular techniques, with the overarching goal of improving patient outcomes in complex aortic pathologies.
The first study, an RCT, investigated the impact of saline flush volume on air embolism during EVAR. Contrary to current theories, the study demonstrated that following the device-specific IFU, rather than increasing saline flush volume, significantly improved deairing efficacy. This finding underscores the importance of strict procedural technique and highlights the influence of endograft design on deairing efficacy.
The second study examined the long-term outcomes of OSSAF for cTBAD. Over a 20-year period, the study revealed high perioperative mortality associated with OSSAF. However, it also demonstrated acceptable long-term survival rates and a unique protective effect against visceral aortic dilation. This suggests that while OSSAF remains a viable option for certain patients, careful patient selection and procedural expertise are crucial to mitigate risks and optimize outcomes.
The third study evaluated the feasibility and safety of BECS for treating complications at the CFA vascular access site. This retrospective analysis demonstrated high technical success rates with BECS. However, it also revealed significant mortality risks, particularly in the short- and mid-term. This highlights the need for cautious application of BECS and emphasizes the importance of rigorous patient selection, standardized procedural techniques, and thorough post-procedural monitoring. Furthermore, this study strongly suggests that until more data is available, this treatment should be performed in the context of clinical trials.
Collectively, these studies contribute to a deeper understanding of the evolving landscape of aortic surgery. They highlight the ongoing effort to refine both established open techniques and contemporary endovascular procedures. While each study addresses distinct clinical scenarios, they are unified by the common goal of improving patient safety and achieving better long-term outcomes in the treatment of complex aortic diseases. They also highlight the necessity of meticulous technique, device specific protocols, and ongoing research to optimize patient care.
