Initial results of complex endovascular interventions for the treatment of aortic disease in Hungary
Borzsák Sarolta
Theoretical and Translational Medicine
Dr. Kellermayer Miklós
SE Városmajori Szív- és Érgyógyászati Klinika
2023-09-25 15:00:00
Cardiovascular Disorders: Physiology and Medicine of Ischaemic Circulatory Diseases
Dr. Merkely Béla
Csobay-Novák Csaba
Dr. Horváthy Dénes
Dr. Galambos Barnabás
Dr. Radovits Tamás
Dr. Hevér Tímea
Dr. Lakatos Bálint
Dr. Végh Eszter
As endovascular treatment possibilities emerge, management of aortic and aorto-iliac pathologies shifts towards endovascular procedures in patients with suitable anatomy. Recent developments involve fenestrated and branched endovascular aneurysm repair (FBEVAR), which provide an opportunity to use a suprarenal proximal landing zone, iliac branch devices (IBD), which preserve the internal iliac arteries even if there is a coexisting dilatation of the aorta and the iliac system, and physician modified endografts (PMEG), which are of great use when treating urgent cases, especially if unusual anatomy is present.
We aimed to evaluate the risk associated with the learning curve of starting a complex aortic program in a tertiary vascular center in Hungary. Therefore, we performed retrospective studies to assess the initial- and midterm results of the first twenty FBEVAR and first thirty-seven IBD implantations in our institution.
The initial outcome of the FBEVAR and IBD procedures showed high technical success with high freedom from disease-related mortality. The 100% per vessel technical success rates of the FBEVAR and IBD deployments were exceptional, especially since this was observed among the initial cases of a newly established center.
Regarding our incipient PMEG cases, excellent technical and clinical success was achieved.
The safe introduction and favorable outcomes of FBEVAR and IBD treatment in our institution could be a result of the few physicians performing the implantations and their previous expertise in the endovascular field. Despite the drawback related to the financial background of these procedures in Hungary, the implantations showed good results and were safe.
Additionally, based on our first PMEG cases, we believe that PMEG can be used effectively in high-volume aortic centers in elective cases in patients with unusual anatomy or in urgent cases of complex aortic pathologies.
