title: Results of the Gore Hybrid Vascular Graft in Challenging Aortic Branch Revascularization during Complex Aneurysm Repair.
abstract: BACKGROUND
  Prolonged organ ischemia during complex aortic surgery is associated with increased morbidity and mortality. A novel hybrid graft (Gore Hybrid Vascular Graft) as composite of expanded polytetrafluorethylene vascular prosthesis that has a section reinforced with nitinol was investigated for feasibility and effectiveness during aortic repair.
  
  
  METHODS
  Retrospective analysis of all consecutive patients treated with the hybrid vascular graft (HVG). Indication for graft implantation was surgeon's preference for branch revascularization in challenging aortic repair.
  
  
  RESULTS
  Within 26 months, 25 Gore HVGs and 17 conventional grafts were implanted in 12 patients (age, 73 years; range, 33-79 years, 8 men). Eleven patients were treated for thoracoabdominal aortic aneurysms and one for aortoiliac aneurysm (elective = 6, urgent = 6). Nine visceral debranching procedures, 2 Crawford procedures, and 1 repair of an internal iliac aneurysm were performed. The distribution of HVG use was left renal artery = 10, right renal artery = 9, superior mesenteric artery = 4, celiac trunk = 1, and internal iliac artery = 1. Time to restore visceral blood flow during visceral debranching was 7 ± 4 min for the Gore HVG vs. 12 ± 6 min for conventional grafts (P < 0.01).Technical success was achieved in all cases. At 12 months of median follow-up, cumulative patency of the HVGs was 96%.
  
  
  CONCLUSIONS
  The Gore HVG offers a new, simplified, and time-sparing technique for visceral anastomoses during complex aneurysm repair. However, long-term results are still lacking and need to be awaited.
authors.affiliation: Department of Vascular Medicine, University Heart Center, Hamburg, Germany. Electronic address: n.tsilimparis@uke.de.
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Tsilimparis
authors.affiliation: Department of Vascular Medicine, University Heart Center, Hamburg, Germany.
authors.forename: Axel
authors.initials: A
authors.lastname: Larena-Avellaneda
authors.affiliation: Department of Vascular Medicine, University Heart Center, Hamburg, Germany.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Krause
authors.affiliation: Department of Vascular Medicine, University Heart Center, Hamburg, Germany.
authors.forename: Sabine
authors.initials: S
authors.lastname: Wipper
authors.affiliation: Department of Vascular Medicine, University Heart Center, Hamburg, Germany.
authors.forename: Holger
authors.initials: H
authors.lastname: Diener
authors.affiliation: Department of Vascular Medicine, University Heart Center, Hamburg, Germany.
authors.forename: Tilo
authors.initials: T
authors.lastname: Kölbel
authors.affiliation: Department of Vascular Medicine, University Heart Center, Hamburg, Germany.
authors.forename: E Sebastian
authors.initials: ES
authors.lastname: Debus
mesh_terms: D000328:Adult; D000368:Aged; D000497:Alloys; D001014:Aortic Aneurysm / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D001027:Aortography / Q000379:methods; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation*; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011138:Polytetrafluoroethylene; D011474:Prosthesis Design; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014654:Vascular Patency
chemical_list: D000497:Alloys; C013616:nitinol; D011138:Polytetrafluoroethylene