title: Thoracic endovascular aortic repair in patients with prior open aortic surgery.
abstract: OBJECTIVE
  To review our experience of thoracic endovascular aortic repair (TEVAR) in patients with prior open aortic repair (OAR).
  
  
  METHODS
  Stent-grafts were deployed in the arch, descending thoracic and thoracoabdominal aortae of 39, 13 and 5 patients, respectively, and in a deteriorated extra-anatomical prosthesis in one. The access route was the femoral artery in 10 of 23 patients with, and in 30 of 35 patients without a prior abdominal prosthesis. Prior prostheses and elephant trunks comprised 57 of 116 landing zones and 23 proximal landing zones, respectively.
  
  
  RESULTS
  Three patients died before discharge. Type II endoleaks developed in six patients, and Types I and III developed in one patient each. Type I endoleaks were not found at landing zones comprising prosthetic grafts. The overall actuarial three-year survival rate including early mortality was 86.5%.
  
  
  CONCLUSIONS
  The clinical outcomes of TEVAR were excellent, even in patients with prior OAR. Prosthetic grafts, including elephant trunks, provided good landing zones for TEVAR. Prostheses with larger-caliber designs are recommended for iliac artery reconstruction in future TEVAR.
authors: Department of Cardiovascular Surgery, Keio University, Tokyo, Japan.
authors: Hideyuki
authors: H
authors: Shimizu
authors: Akihiro
authors: A
authors: Yoshitake
authors: Satoshi
authors: S
authors: Kawaguchi
authors: Shinji
authors: S
authors: Kawaguchi
authors: Hidenobu
authors: H
authors: Takaki
authors: Ryohei
authors: R
authors: Yozu
keywords: aneurysm; reoperation; stent graft
references: Gen Thorac Cardiovasc Surg. 2010 Oct;58(10):501-5
references: 20941562
references: Ann Surg. 1997 Nov;226(5):599-605
references: 9389393
references: Eur J Cardiothorac Surg. 2009 May;35(5):906
references: 19269840
references: Ann Thorac Surg. 2011 Dec;92(6):2266-8
references: 22115246
references: J Thorac Cardiovasc Surg. 2010 Jun;139(6):1464-72
references: 20494193
references: Semin Thorac Cardiovasc Surg. 2009 Winter;21(4):347-54
references: 20226349
references: Ann Thorac Surg. 2009 Sep;88(3):758-66; discussion 767
references: 19699894
references: J Thorac Cardiovasc Surg. 2004 Nov;128(5):669-76
references: 15514593
references: J Thorac Cardiovasc Surg. 2009 Mar;137(3):627-34
references: 19258079
references: Gen Thorac Cardiovasc Surg. 2007 Feb;55(2):76-9
references: 17444182
references: J Vasc Surg. 2007 Jun;45(6):1128-35
references: 17543675
references: Interact Cardiovasc Thorac Surg. 2012 May;14(5):529-31
references: 22345060