Dokument: Outcome of Single Versus Dual Antiplatelet Therapy After Complex Endovascular Aortic Repair

Titel:Outcome of Single Versus Dual Antiplatelet Therapy After Complex Endovascular Aortic Repair
URL für Lesezeichen:https://docserv.uni-duesseldorf.de/servlets/DocumentServlet?id=68079
URN (NBN):urn:nbn:de:hbz:061-20250109-125918-1
Kollektion:Publikationen
Sprache:Englisch
Dokumententyp:Wissenschaftliche Texte » Artikel, Aufsatz
Medientyp:Text
Autoren: Mulorz, Joscha [Autor]
Costanza, Laura M. [Autor]
Vockel, Malwina [Autor]
Mazrekaj, Agnesa [Autor]
Arnautovic, Amir [Autor]
Garabet, Waseem [Autor]
Oberhuber, Alexander [Autor]
Schelzig, Hubert [Autor]
Wagenhäuser, Markus Udo [Autor]
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Stichwörter:Complex endovascular aortic repair, Antiplatelet therapy, Branched endovascular aortic repair, Fenestrated endovascular aortic repair, Target vessel patency
Beschreibung:Introduction
Despite the widespread use of branched (bEVAR) and fenestrated endovascular aortic repair (fEVAR) for complex aortic pathologies, there are no reliable recommendations regarding postsurgery antiplatelet therapy. We therefore evaluated the outcome of single (SAPT) and dual antiplatelet therapy (DAPT) following fEVAR and bEVAR.
Methods
A total of 63 patients from two German centers treated for complex aortic pathologies were included in this retrospective study. Patient data and computed tomography angiograms were analyzed. Kaplan–Meier analyses for overall survival and freedom from target vessel (TV)-related complications were performed. The outcomes were compared between SAPT versus DAPT and bEVAR versus fEVAR. Univariate logistic regression was applied to analyze the correlation between TV patency and various anatomical aortic parameters.
Results
In total, 30 patients were treated with fEVAR and 33 with bEVAR. Of these, 19 patients received SAPT and 44 received DAPT postsurgery. Anatomical aortic characteristics and comorbidities were comparable among groups. Overall survival was 95% (±5.1) for SAPT and 88% (±8.8) for DAPT after 36 mo of follow-up. Patency was evaluated individually for each TV SAPT versus DAPT (celiac trunk 100% ± 0 versus 87% ± 9.6; superior mesenteric artery 86% ± 13.2 versus 100% ± 0; left renal artery 92% ± 8.0 versus 95% ± 3.6; right renal artery 72% ± 15.2 versus 81% ± 9.9). Freedom from endoleak was 35% (±13.7) for SAPT versus 30% (±13.8) for DAPT. There was no statistically significant difference for SAPT versus DAPT or for bEVAR versus fEVAR. Further, none of the anatomical aortic characteristics and bridging stent graft-related parameters analyzed predicted TV occlusion in logistic regression analysis.
Conclusions
We did not observe differences in overall survival, endoleak, and TV patency rates between SAPT and DAPT treated patients following bEVAR and/or fEVAR. Patient-specific factors therefore appear to be more relevant for the long-term outcomes rather than the antiplatelet regime applied postsurgery.
Rechtliche Vermerke:Originalveröffentlichung:
Mulorz, J., Costanza, L. M., Vockel, M., Mazrekaj, A., Arnautovic, A., Garabet,
W., Oberhuber, A., Schelzig, H., & Wagenhäuser, M. (2024). Outcome of Single
Versus Dual Antiplatelet Therapy After Complex Endovascular Aortic Repair. The
Journal of Surgical Research, 305, 171–182.
https://doi.org/10.1016/j.jss.2024.11.018
Lizenz:Creative Commons Lizenzvertrag
Dieses Werk ist lizenziert unter einer Creative Commons Namensnennung 4.0 International Lizenz
Fachbereich / Einrichtung:Medizinische Fakultät
Dokument erstellt am:09.01.2025
Dateien geändert am:09.01.2025
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