Viabahn Open Rebranching Technique combined with hybrid debranching technique help preventing renal artery obliteration and renal dysfunction aggravation in the treatment of thoracoabdominal aortic aneurysms

Abstract

OBJECTIVE: Hybrid debranching technique combined with conventional open surgery and endovascular repair was an effective treatment for thoracoabdominal aortic aneurysm (TAAA). We propose a new technique to reduce the time of RA anastomosis. MATERIALS AND METHODS: The hybrid staged operation procedure was evaluated in the period of 2013 and 2017 in three academic centers. The bilateral renal artery anastomosis in the experimental group used VORTEC technique. In the control group, the bilateral renal artery reconstruction was performed by conventional artificial blood vessel anastomosis. Primary outcome was technical success, the time of renal artery anastomosis, and major complications. Long term follow-up up to 7 years was evaluated as well. RESULTS: In total 57 patients were enrolled. Compared with the control group, there was a statistical difference in the mean time of left RA anastomosing (19.8 vs 4.6 min, p<0.001) and the right RA anastomosing (20.5 vs 4.6 min, p<0.001) in the experimental group. While the aggravation of renal dysfunction occurred in 12 patients in 1 year after the stage surgery, and there was a statistical difference between the experimental group and the control group (4 vs 8, p=0.025). CONCLUSION: The VORTEC technique could help reducing the time of RA anastomosing and get lower complication rate and better effect during long-term follow up.

Keywords

• hybrid debranching; vortec technique; sutureless anastomosis; thoracoabdominal aortic aneurysm; renal dysfunction