title: Operative outcomes using a side-branched thoracoabdominal aortic graft (STAG) for thoraco-abdominal aortic repair.
abstract: BACKGROUND
  Pre-manufactured branched grafts now allow an endovascular approach to the repair of thoraco-abdominal aortic aneurysm (TAAA) with visceral vessels' involvement. Similar grafts have been employed in open surgery, generally as a second choice for TAAAs, which are not amenable to patch/inclusion technique for visceral vessel attachment. Results with branched grafts have not been reported in series of open TAAA repairs. The purpose of this report is to describe perioperative risks and outcomes in a consecutive series of patients with pre-manufactured side-branched thoracoabdominal aortic grafts (STAGs) for surgical TAAA repair.
  
  
  METHODS
  Between 1996 and 2009, pre-manufactured STAGs were used in 50 patients with TAAA that required reattachment of the visceral and renal arteries. Operative details, perioperative mortality and ischaemic complications were examined.
  
  
  RESULTS
  Mean age was 53 years; 18 patients were females. The cases included redo (n = 24), patients affected by genetic disorder (Marfan) (n = 20) and patients with aortic dissection (n = 27). The mean clamp time was 84.1 min. Perioperative mortality was 12.0% (6/50). Neurologic deficits occurred in 2% (1/50). Postoperative renal dysfunction was detected in 19 patients (38%).
  
  
  CONCLUSIONS
  The use of a STAG produced acceptable mortality, bowel and neurological ischaemic risks. Improved strategies to prevent renal ischaemia before and during repair of TAAA with visceral involvement are needed.
authors.affiliation: Division of Vascular and Endovascular Surgery, University of Perugia, Ospedale S. Maria della Misericordia, Perugia, Italy.
authors.forename: P
authors.initials: P
authors.lastname: De Rango
authors.forename: A L
authors.initials: AL
authors.lastname: Estrera
authors.forename: C
authors.initials: C
authors.lastname: Miller
authors.forename: T-Y
authors.initials: TY
authors.lastname: Lee
authors.forename: K
authors.initials: K
authors.lastname: Keyhani
authors.forename: S
authors.initials: S
authors.lastname: Abdullah
authors.forename: H
authors.initials: H
authors.lastname: Safi
mesh_terms: D000714:Anastomosis, Surgical; D017545:Aortic Aneurysm, Thoracic / Q000401:mortality / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods; D002445:Celiac Artery / Q000601:surgery; D005260:Female; D005263:Femoral Artery / Q000601:surgery; D006801:Humans; D008297:Male; D017538:Mesenteric Artery, Superior / Q000601:surgery; D008875:Middle Aged; D011093:Polyethylene Terephthalates; D011183:Postoperative Complications; D011474:Prosthesis Design; D012077:Renal Artery / Q000601:surgery; D051437:Renal Insufficiency / Q000209:etiology; D012189:Retrospective Studies
chemical_list: D011093:Polyethylene Terephthalates