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SEIT 1386

SEIT 1386. Febbraio – luglio 2013. Heidelberg. Stato federale: Baden-Württemberg Popolazione: 150.000. Chirurgia Vascolare – Gefäßchirurgie Prof. Dr. med. Dittmar Böckler. Ärztlicher Direktor Prof. Dr. med. Dittmar Böckler Leitender Oberarzt PD Dr. med. Alexander Hyhlik-Dürr Oberärzte

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SEIT 1386

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  1. SEIT 1386

  2. Febbraio – luglio 2013 Heidelberg Stato federale: Baden-Württemberg Popolazione: 150.000 .

  3. Chirurgia Vascolare – Gefäßchirurgie Prof. Dr. med. Dittmar Böckler

  4. Ärztlicher Direktor Prof. Dr. med. Dittmar Böckler Leitender Oberarzt PD Dr. med. Alexander Hyhlik-Dürr Oberärzte Dr. med. Ulrike Burger Dr. med. Andreas Ofenloch Dr. med. Nicolas Attigah Dr. med. Maani Hakimi Dr. med. Philipp Geisbüsch 

  5. Fachärte Dr. med. Serdar Demirel Dr. med. Drosos Kotelis Sabine Pfeiffer Ärzte in der Weiterbildung Dr. med. Moritz Bischoff Dr. med. Andreas Peters Dr. med. Carola Wieker Philipp Erhart Markus Wortman A. Bender Rotationsassistenten Dr. med. Leila Sisic

  6. Endostapler applier • EndoAnchor cassette (x10) • 16F Guide with Obturator • (18F for thoracic guide)

  7. Stuttgart – 14-15 June 2013

  8. Follow-up outcomes of hybrid procedures for thoracoabdominal aortic pathologies with special focus on graft patency and late mortality Bianchini Massoni C, Geisbüsch P, Gallitto E, Hakimi M, Gargiulo M, Böckler D Submitted to J Vasc Surg

  9. Introduction

  10. Introduction

  11. Methods Retrospectively analysis 2-center study • January 2001 - December 2012 • Hybrid treatment for thoracoabdominal aortic pathologies

  12. Methods 45 patients 33 (73.3%) males, mean age: 67.8 ± 7.6 2 5 7

  13. Methods * median delay: 19 days (range 7-89)

  14. Methods 30-day outcomes • technical success • morbidity • bypass graft patency • survival

  15. Methods Follow-up outcomes • morbidity • bypass graft patency • survival Mean follow-up: 2.9 years ± 2.4

  16. Methods Follow-up outcomes Fisher‑exact test or chi-square test Kaplan-Meier life-table analysis T‑test Mann-Whitney test Long-rank test Statistical significance : P ≤ .05 SPSS software (version13.0; SPSS Inc, Chicago, IL, USA)

  17. Results Technical success: 86.6%

  18. Results 30-day morbidity: 60% Patients with postoperative complication needed a longer recovery in intensive care unit (P=.02)

  19. Results 30-day morbidity: 60% Patients with postoperative complication needed a longer recovery in intensive care unit (P=.02)

  20. Results 30-day bypass graft patency: 92.9% Thrombosis: 11 (7.1%) in 9 (20%) patients Stenosis: 0

  21. Results 30-day bypass graft patency: 92.9%

  22. Results 30-day bypass graft patency: 92.9%

  23. Results 30-day overall mortality: 24.4%

  24. Results 30-day overall mortality: 24.4%

  25. Results 30-day overall mortality: 24.4%

  26. Results 30-day overall mortality: 24.4%

  27. Results 30-day mortality 30-day morbidity Paraplegia Renal impairment Dialysis +

  28. Results Primary patency Thrombosis: 6 (4.5%) in 5 (13.1%) patients Stenosis: 3 (2.3%) stenosis in 2 (5.3%) patients

  29. Results Primary patency

  30. Results Primary patency

  31. Results Primary patency

  32. Results Primary patency by site of in-flow anastomosis P = .035

  33. Results Overall and aortic-related mortality

  34. Results Overall mortality

  35. Results Aortic-related mortality: 4 (8.9%)

  36. Conclusion • 30-day complications and mortality is significant • No definitive evidence of superiority of staged over simultaneous approach are founded

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