title: Simultaneous Endovascular Repair for Thoracic and Abdominal Aortic Pathologies: Early and Midterm Results.
abstract: BACKGROUND
  To analyze information from a single clinical center, evaluating early and midterm results of simultaneous thoracic endovascular aortic repair (TEVAR) and endovascular aneurysm repair (EVAR) for coexisting thoracic and abdominal aortic pathologies.
  
  
  METHODS
  From January 2005 to December 2014, 13 patients (8 men, 5 women; mean age, 75.3 years; range, 69-82 years) with concomitant thoracic and abdominal aortic disease (aneurysms, type B dissection, penetrating aortic ulcers) were treated with simultaneous TEVAR and EVAR. All patients had significant comorbidities. No preoperative cerebrospinal fluid drainage was performed. The follow-up rate was 100% during a period of 36 months (range, 1-60 months).
  
  
  RESULTS
  Technical success was achieved in all 13 patients, including deliberate partial or total coverage of the left subclavian artery in 3 patients, coverage of both internal iliac arteries in 1 patient, and coverage of left subclavian artery and unilateral internal iliac artery in 1 patient. The average procedural time was 160 min (range, 120-200 min). Mean blood loss was 140 mL (range, 100-250 mL). Four types of commercially available stent grafts (SGs) were used. The lengths of the thoracic SGs were 150-200 cm. Overall survival was 92.3% at 1- and 3-year follow-ups. None of the patients developed stroke or paralysis. The average hospital stay was 9 days (range, 7-12 days). No patients developed endoleak or SG migration.
  
  
  CONCLUSIONS
  Combined TEVAR and EVAR can be performed successfully with minimal morbidity and mortality. When anatomically feasible, simultaneous TEVAR and EVAR is a viable alternative to staged or hybrid repair.
authors.affiliation: Department of Vascular Surgery, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, PR China.
authors.forename: Yuanyuan
authors.initials: Y
authors.lastname: Guo
authors.affiliation: Department of Vascular Surgery, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, PR China.
authors.forename: Hongbo
authors.initials: H
authors.lastname: Cai
authors.affiliation: Department of Vascular Surgery, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, PR China.
authors.forename: Bin
authors.initials: B
authors.lastname: Yang
authors.affiliation: Department of Vascular Surgery, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, PR China. Electronic address: jinhui_kmu@126.com.
authors.forename: Hui
authors.initials: H
authors.lastname: Jin
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000784:Aortic Dissection / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D001027:Aortography / Q000379:methods; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation / Q000401:mortality; D002681:China; D000072226:Computed Tomography Angiography; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation / Q000401:mortality; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D011183:Postoperative Complications / Q000209:etiology; D011474:Prosthesis Design; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014456:Ulcer / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*