Five-year Patency Rates of Renal and Visceral Bypasses after Abdominal Debranching for Thoraco-abdominal Aortic Aneurysms

Abstract

This article aims to report for the first time the long-term bypass graft patency after visceral hybrid repair of thoraco-abdominal aortic aneurysms (TAAAs). Between July 2004 and September 2012 the visceral hybrid procedure was performed in 46 patients with TAAAs, who did not qualify for an open or total endovascular repair. The inflow sites of visceral revascularisation originated either from the native artery or from aortic prosthetic grafts. All patients were included in the study and were followed up with subsequent computed tomography (CT) (mean follow-up 23.5 months). In 46 patients (67.5 years in median; range 35-88), 164 grafts were performed. The 30-day primary patency of all grafts was 87.9%. The long-term patency remained 87.9 ± 2.7%, 86.1 ± 3.2% and 86.1 ± 3.2% after 1, 3 and 5 years, respectively. The patency of all hepatic grafts was 100%. The patency of grafts to the superior mesenteric artery was 88.8 ± 4.8% after 1, 3 and 5 years. The patency was 87.2 ± 6%, 87.2 ± 6% and 87.2 ± 6% for the left renal artery and 76 ± 7%, 69.6 ± 8.8% and 69.6 ± 8.8% for the right renal artery after 1, 3 and 5 years, respectively. Hybrid repair demonstrates excellent results regarding long-term bypass graft patency of renovisceral arteries except for the right renal artery.