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Article ; Online: Near-wall hemodynamic parameters of finger arteries altered by hand-transmitted vibration.

Noël, Christophe / Settembre, Nicla

2023 Volume 168, Page(s) 107709

Abstract: Background: Sustained exposure to high-level hand-transmitted vibrations may result in angioneurotic disorders, which partly originate from vibration-altered hemodynamics in the finger arteries when repeating these disturbances throughout working life. ... ...

Abstract	Background: Sustained exposure to high-level hand-transmitted vibrations may result in angioneurotic disorders, which partly originate from vibration-altered hemodynamics in the finger arteries when repeating these disturbances throughout working life. Hence, the aim of this study is to assess the most relevant hemodynamic descriptors in the digital arteries, determine the relationship between the latter and vibration features, and gain better understanding of the physiological mechanisms involved. Methods: An experimental setup, mainly comprised of an ultra-high frequency ultrasound scanner and a vibration shaker, was used to image the digital proper volar arteries of the forefinger. Raw ultrasound data were post-processed by custom-made numerical routines to supply a pulsatile fluid mechanics model for computing the hemodynamic descriptors. Twenty-four healthy volunteers participated in the measurement campaign. Classical statistical methods were then applied to the dataset and also the wavelet transform for calculating the signal power in the frequency bands matching cardiac, respiratory, myogenic and neurogenic activities. Results: The artery diameter, the wall shear stress - WSS - and the WSS temporal gradient - WSSTG - were found to be the most relevant descriptors. Vibration-induced WSS was divided by three compared to its basal value whatever the vibration frequency and it was proportional to log Conclusion: This study may pave the way for a new framework to prevent vibration-induced vascular risk.
MeSH term(s)	Humans ; Vibration/adverse effects ; Hand ; Hemodynamics ; Fingers/blood supply ; Arteries
Language	English
Publishing date	2023-11-20
Publishing country	United States
Document type	Journal Article
ZDB-ID	127557-4
ISSN	1879-0534 ; 0010-4825
ISSN (online)	1879-0534
ISSN	0010-4825
DOI	10.1016/j.compbiomed.2023.107709
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Article ; Online: Assessing mechanical vibration-altered wall shear stress in digital arteries.

Noe L, Christophe / Settembre, Nicla

Journal of biomechanics

2021 Volume 131, Page(s) 110893

Abstract: The aim of this study is to implement and validate a method for assessing acute vibration-altered Wall Shear Stress (WSS) in the proper volar digital artery of the non-exposed left forefinger when subjecting the right hand to mechanical vibration. These ... ...

Abstract	The aim of this study is to implement and validate a method for assessing acute vibration-altered Wall Shear Stress (WSS) in the proper volar digital artery of the non-exposed left forefinger when subjecting the right hand to mechanical vibration. These changes of WSS may be involved in Vibration White Finger. Hence, an experimental device was set-up to link a vibration shaker and an ultra-high frequency ultrasound scanner. The Womersley-based WSS was computed by picking up the maximum velocity from pulse Wave Doppler measurements and extracting the artery diameter from B-mode images through an in-house image processing technique. The parameters of the former method were optimised on numerical ultrasound phantoms of cylindrical and lifelike arteries. These phantoms were computed with the FIELD II and FOCUS platforms which mimicked our true ultrasound device. The Womersley-based WSS were compared to full Fluid Structure Interaction (FSI) and rigid wall models built from resonance magnetic images of a volunteer-specific forefinger artery. Our FSI model took into account the artery's surrounding tissues. The diameter computing procedure led to a bias of 4%. The Womersley-based WSS resulted in misestimating the FSI model by roughly 10% to 20%. No difference was found between the rigid wall computational model and FSI simulations. Regarding the WSS measured on a group of 20 volunteers, the group-averaged basal value was 3 Pa, while the vibration-altered WSS was reduced to 1 Pa, possibly triggering intimal hyperplasia mechanisms and leading to the arterial stenoses encountered in patients suffering from vibration-induced Raynaud's syndrome.
MeSH term(s)	Arteries/diagnostic imaging ; Blood Flow Velocity ; Computer Simulation ; Humans ; Models, Cardiovascular ; Shear Strength ; Stress, Mechanical ; Vibration
Language	English
Publishing date	2021-12-20
Publishing country	United States
Document type	Journal Article
ZDB-ID	218076-5
ISSN	1873-2380 ; 0021-9290
ISSN (online)	1873-2380
ISSN	0021-9290
DOI	10.1016/j.jbiomech.2021.110893
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Zs.A 700: Show issues

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Article ; Online: Da Vinci Robotic Assistance for Anterolateral Lumbar Arthrodesis: Results of a French Multicentric Study.

Loniewski, Stanislas / Farah, Kaissar / Mansouri, Nacer / Albader, Faisal / Settembre, Nicla / Litré, Claude-Fabien / Malikov, Serguei / Fuentes, Stéphane

World neurosurgery

2023 Volume 181, Page(s) e685–e693

Abstract: Background: The da Vinci robot (DVR) is the most widely used robot in abdominal, urological, and gynecological surgery. Due to its minimally invasive approach, the DVR has demonstrated its effectiveness and improved safety in these different disciplines. ...

Abstract	Background: The da Vinci robot (DVR) is the most widely used robot in abdominal, urological, and gynecological surgery. Due to its minimally invasive approach, the DVR has demonstrated its effectiveness and improved safety in these different disciplines. The aim of our study was to report its use in an anterior approach of complex lumbar surgery. Methods: In a retrospective multicenter observational study, 10 robotic-assisted procedures were performed from March 2021 to May 2022. Six oblique lumbar interbody fusion procedures and 4 lumbar corpectomies were performed by anterolateral approach assisted by the DVR. The characteristics of the patients and the intraoperative and postoperative data were recorded. Results: Six men and 4 women underwent surgery (mean age 50.5 years; body mass index 28.6 kg/m Conclusions: The use of the DVR in lumbar surgery allows a safe minimally invasive transperitoneal approach, but to date, only hybrid procedures have been performed.
MeSH term(s)	Male ; Humans ; Female ; Middle Aged ; Robotics ; Robotic Surgical Procedures ; Spinal Fusion/methods ; Lumbosacral Region/surgery ; Radiography ; Lumbar Vertebrae/surgery ; Retrospective Studies ; Minimally Invasive Surgical Procedures/methods ; Treatment Outcome
Language	English
Publishing date	2023-10-26
Publishing country	United States
Document type	Multicenter Study ; Observational Study ; Journal Article
ZDB-ID	2534351-8
ISSN	1878-8769 ; 1878-8750
ISSN (online)	1878-8769
ISSN	1878-8750
DOI	10.1016/j.wneu.2023.10.114
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Zs.A 1159: Show issues

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Article ; Online: Surgical Management of Carotid Body Tumors: Experience of Two Centers.

Pouhin, Alexandre / Die Loucou, Julien / Malikov, Sergueï / Gallet, Patrice / Anxionnat, Rene / Jazayeri, Aline / Steinmetz, Eric / Settembre, Nicla

Annals of vascular surgery

2023 Volume 98, Page(s) 1–6

Abstract: Background: Carotid body tumors (CBTs) are rare but require surgical resection given their potential for growth and malignancy. For some surgical teams, tumor hypervascularity justifies preoperative embolization to facilitate resection and limit ... ...

Abstract	Background: Carotid body tumors (CBTs) are rare but require surgical resection given their potential for growth and malignancy. For some surgical teams, tumor hypervascularity justifies preoperative embolization to facilitate resection and limit complications. The objective of our study was to evaluate 2 different practices of surgical resection with or without preoperative embolization in a 2-center cohort. Methods: A consecutive series of patients who underwent CBT surgery, from January 2011 to June 2019, were divided into 2 groups, as to whether they were (embolized CBT [ECBT]) or not (nonembolized CBT [NECBT]) preoperatively embolized. Both groups were compared specifically according to the duration of operation, postoperative complications, and length of stay. Results: Twenty-two patients with a mean age of 48.5 ± 14.3 years were included. In the series, 23 CBTs were resected: 13 were embolized preoperatively; the mean time between embolization and surgery was 2.62 ± 1.50 days. Both groups were comparable based on characteristics of population and tumor, with a mean size of 33.2 ± 11.9 mm. We noted a significant increase in operation duration in the ECBT group: 151 min (±40.9) vs. 87.0 min (±21); P < 0.01. There was no difference between the 2 groups regarding cranial nerve (50% vs. 46%; P = 1), sympathetic nervous system (20% vs. 23%; P = 1), or vascular nerve (20% vs. 23%; P = 0.18) complications. No cerebrovascular accident was identified. The length of stay was 3.60 days (±1.78) vs. 3.73 days (±1.19; P = 0.44). Conclusions: This study reflects the experience of 2 centers in the management of CBT which is a rare pathology with no standardized treatment. Our series showed no significant difference between the ECBT and NECBT groups regarding postoperative complications and length of hospital stay. The reduction in operating time in the NECBT group remains to be demonstrated.
MeSH term(s)	Humans ; Adult ; Middle Aged ; Carotid Body Tumor/diagnostic imaging ; Carotid Body Tumor/surgery ; Carotid Body Tumor/pathology ; Retrospective Studies ; Treatment Outcome ; Embolization, Therapeutic/adverse effects ; Postoperative Complications/etiology ; Vascular Surgical Procedures/adverse effects
Language	English
Publishing date	2023-10-14
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	1027366-9
ISSN	1615-5947 ; 0890-5096
ISSN (online)	1615-5947
ISSN	0890-5096
DOI	10.1016/j.avsg.2023.08.025
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Zs.A 2882: Show issues

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Article ; Online: Nationwide Study in France To Predict One Year Major Bleeding and Validate the OAC3-PAD Score in Patients Undergoing Revascularisation for Lower Extremity Arterial Disease.

Lareyre, Fabien / Behrendt, Christian-Alexander / Pradier, Christian / Settembre, Nicla / Chaudhuri, Arindam / Fabre, Roxane / Raffort, Juliette / Bailly, Laurent

European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery

2023 Volume 66, Issue 2, Page(s) 213–219

Abstract: Objective: Antithrombotic strategies are currently recommended for the treatment of lower extremity artery disease (LEAD) but specific scores to assess the risk of bleeding in these patients are scarce. To fill the gap, the OAC3-PAD bleeding score was ... ...

Abstract	Objective: Antithrombotic strategies are currently recommended for the treatment of lower extremity artery disease (LEAD) but specific scores to assess the risk of bleeding in these patients are scarce. To fill the gap, the OAC3-PAD bleeding score was recently developed and validated in German cohorts. The aim of this study was to determine whether this score performs appropriately in another real world nationwide cohort. Methods: This 10 year retrospective, multicentre study based on French national electronic health data included patients who underwent revascularisation for LEAD between January 2013 and June 2022. The OAC3-PAD score was calculated and from this, the population was classified into four groups: low, low to moderate, moderate to high and high risk. A binary logistic regression model was applied, with major bleeding occurring at one year (defined using the International Classification of Diseases ICD-10) as the dependent variable. The performance of the OAC3-PAD bleeding score was investigated using a receiver operating characteristic curve. Results: Among 161 205 patients hospitalised for LEAD treatment in French institutions, the one year incidence of major bleeding was 13 672 patients (8.5%). The distribution of the population according to the OAC3-PAD bleeding score was: 88 835 patients (55.1%), 34 369 (21.3%), 27 914 (17.3%), and 10 087 (6.3%) in the low, low to moderate, moderate to high, and high risk groups, respectively; with an incidence of one year major bleeding of 5.0%, 9.8%, 13.2%, and 21.3%. The OAC3-PAD model achieved an AUC of 0.650 to predict one year major bleeding following LEAD repair (95% CI 0.645 - 0.655), with a sensitivity of 0.67 and a specificity of 0.57. Conclusion: This nationwide analysis confirmed the accuracy of the OAC3-PAD model to predict one year major bleeding and served as external validation. Although further studies are required, it adds evidence and perspectives to further generalise its use to guide the management of patients with LEAD.
MeSH term(s)	Humans ; Retrospective Studies ; Peripheral Arterial Disease/diagnosis ; Peripheral Arterial Disease/surgery ; Peripheral Arterial Disease/epidemiology ; Hemorrhage/chemically induced ; Hemorrhage/epidemiology ; Vascular Surgical Procedures/adverse effects ; Lower Extremity/blood supply ; Risk Factors
Language	English
Publishing date	2023-04-28
Publishing country	England
Document type	Multicenter Study ; Journal Article
ZDB-ID	1225869-6
ISSN	1532-2165 ; 1078-5884
ISSN (online)	1532-2165
ISSN	1078-5884
DOI	10.1016/j.ejvs.2023.04.026
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Zs.A 2283: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
Zs.MO 381: Show issues

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Article ; Online: The omental free flap and flow-through flap: pre-operative evaluation of right gastro-omental artery on multidetector computed tomography.

Settembre, Nicla / Bouziane, Zakariyae / Mandry, Damien / Braun, Marc / Malikov, Sergueï

Abdominal radiology (New York)

2020 Volume 45, Issue 10, Page(s) 3321–3325

Abstract: Background: The gastro-omental artery (GOA) and the greater omentum are nowadays commonly used in many reconstructive surgeries, including cardiac, vascular, and plastic surgery. There are cases in which the GOA is found to be unsuitable only after ... ...

Abstract	Background: The gastro-omental artery (GOA) and the greater omentum are nowadays commonly used in many reconstructive surgeries, including cardiac, vascular, and plastic surgery. There are cases in which the GOA is found to be unsuitable only after partial harvesting following an upper laparotomy, and an improved method of pre-operative evaluation is required to eliminate the need for intraoperative small laparotomy. Methods: Multidetector computed tomography was performed for 30 consecutive patients admitted for lower limb ischemia in a routine pre-operative evaluation of lower limb peripheral arterial disease (PAD). The origin of the GOA was checked on coronal and sagittal slices, its pathway was identified on the three-dimensional rendering. We assessed length and mean diameter of the distal and proximal right GOA, and the mean distances between the origins of GOA and the omental branches. Finally, we report one case of omental flow-through flap. Results: 30 patients were included in our study. Routine pre-operative MDCT during lower limb PAD workup enabled identification of GOA in all cases. The mean internal diameter of the GOA at its origin was 3.3 mm (± 3.3). The mean internal diameter of the distal GOA was 1.26 mm (± 0.3). At least one omental descending branch was detected in every case and in 63% (19 patients) at least two branches were visualized. Conclusion: Routine pre-operative angio-MDCT imaging is an effective tool to assess precisely the different anatomical properties of the GOA. This exam could be useful for both diagnosis of lower limb PAD and evaluation of the GOA suitability for flow-through flap lower limb revascularisation.
MeSH term(s)	Free Tissue Flaps ; Hepatic Artery ; Humans ; Multidetector Computed Tomography ; Omentum/diagnostic imaging ; Omentum/surgery ; Reconstructive Surgical Procedures
Language	English
Publishing date	2020-03-20
Publishing country	United States
Document type	Journal Article
ZDB-ID	2839786-1
ISSN	2366-0058 ; 2366-004X
ISSN (online)	2366-0058
ISSN	2366-004X
DOI	10.1007/s00261-020-02493-8
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Zs.A 1262: Show issues

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Article ; Online: Stress Analysis in AAA does not Predict Rupture Location Correctly in Patients with Intraluminal Thrombus.

Lorandon, Fanny / Rinckenbach, Simon / Settembre, Nicla / Steinmetz, Eric / Mont, Lucie Salomon Du / Avril, Stephane

Annals of vascular surgery

2021 Volume 79, Page(s) 279–289

Abstract: Background: A biomechanical approach to the rupture risk of an abdominal aortic aneurysm could be a solution to ensure a personalized estimate of this risk. It is still difficult to know in what conditions, the assumptions made by biomechanics, are ... ...

Abstract	Background: A biomechanical approach to the rupture risk of an abdominal aortic aneurysm could be a solution to ensure a personalized estimate of this risk. It is still difficult to know in what conditions, the assumptions made by biomechanics, are valid. The objective of this work was to determine the individual biomechanical rupture threshold and to assess the correlation between their rupture sites and the locations of their maximum stress comparing two computed tomography scan (CT) before and at time of rupture. Methods: We included 5 patients who had undergone two CT; one within the last 6 months period before rupture and a second CT scan just before the surgical procedure for the rupture. All DICOM data, both pre- and rupture, were processed following the same following steps: generation of a 3D geometry of the abdominal aortic aneurysm, meshing and computational stress analysis using the finite element method. We used two different modelling scenarios to study the distribution of the stresses, a "wall" model without intraluminal thrombus (ILT) and a "thrombus" model with ILT. Results: The average time between the pre-rupture and rupture CT scans was 44 days (22-97). The median of the maximum stresses applied to the wall between the pre-rupture and rupture states were 0.817 MPa (0.555-1.295) and 1.160 MPa (0.633-1.625) for the "wall" model; and 0.365 MPa (0.291-0.753) and 0.390 MPa (0.343-0.819) for the "thrombus" model. There was an agreement between the site of rupture and the location of maximum stress for only 1 patient, who was the only patient without ILT. Conclusions: We observed a large variability of stress values at rupture sites between patients. The rupture threshold strongly varied between individuals depending on the intraluminal thrombus. The site of rupture did not correlate with the maximum stress except for 1 patient.
MeSH term(s)	Aged ; Aortic Aneurysm, Abdominal/complications ; Aortic Aneurysm, Abdominal/diagnostic imaging ; Aortic Aneurysm, Abdominal/physiopathology ; Aortic Rupture/diagnostic imaging ; Aortic Rupture/etiology ; Aortic Rupture/physiopathology ; Aortography ; Biomechanical Phenomena ; Computed Tomography Angiography ; Hemodynamics ; Humans ; Imaging, Three-Dimensional ; Male ; Middle Aged ; Models, Cardiovascular ; Patient-Specific Modeling ; Predictive Value of Tests ; Prognosis ; Radiographic Image Interpretation, Computer-Assisted ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Stress, Mechanical ; Thrombosis/complications ; Thrombosis/diagnostic imaging ; Thrombosis/physiopathology ; Time Factors
Language	English
Publishing date	2021-10-12
Publishing country	Netherlands
Document type	Comparative Study ; Journal Article
ZDB-ID	1027366-9
ISSN	1615-5947 ; 0890-5096
ISSN (online)	1615-5947
ISSN	0890-5096
DOI	10.1016/j.avsg.2021.08.008
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Zs.A 2882: Show issues

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Article ; Online: Omental Flow-Through Flap: Experimental Hemodynamic Study.

Settembre, Nicla / Malikov, Sergueï

Annals of vascular surgery

2016 Volume 36, Page(s) 244–251

Abstract: Background: The omental flow-through flap (OFTF) is based on the use of an anatomic unit composed of the right gastro-omental artery (bypass) with its omental branch or branches supplying the greater omentum (flap). The greater omentum flap is known for ...

Abstract	Background: The omental flow-through flap (OFTF) is based on the use of an anatomic unit composed of the right gastro-omental artery (bypass) with its omental branch or branches supplying the greater omentum (flap). The greater omentum flap is known for its capacity of resistance to infection, for its use in the treatment of ischemic lesions and as a high-flow tissue. Several hypotheses regarding the hemodynamic behavior of a distal bypass with a flap were discussed in the literature. We made the assumption that the OFTF was a low peripheral resistance flap and that the greater omentum did not induce a steal phenomenon. We demonstrated the anatomical feasibility of the experimental model with a morphologic study in the pig. The mail objective of this study was to measure the blood flow to evaluate the hemodynamic effects of the OFTF. Methods: Twelve domestic pigs were used for this study. Four cadavers of pigs were dissected for the anatomic study of the OFTF, and 8 live pigs were used for the experimental surgery and hemodynamic measurements. Hemodynamic measurements were taken before transplantation on in situ arteries using periarterial ultrasonic flow transducers. After transplantation of the OFTF, flows were measured before, then during clamping and unclamping of the flap. Results: OFTF was feasible in the porcine model. With the experimental model, the flow increased by 56.15% in the distal part of the bypass after the implantation of the flap with decrease of peripheral resistances. Conclusions: Our results suggest that the OFTF is a low resistance flap and that the greater omentum does not induce a steal phenomenon. This anatomic unit could be used to carry out simultaneously limb revascularization and cover a tissue loss.
MeSH term(s)	Animals ; Blood Flow Velocity ; Feasibility Studies ; Hemodynamics ; Models, Animal ; Omentum/blood supply ; Omentum/transplantation ; Regional Blood Flow ; Surgical Flaps/blood supply ; Sus scrofa ; Vascular Resistance
Language	English
Publishing date	2016-10
Publishing country	Netherlands
Document type	Evaluation Studies ; Journal Article
ZDB-ID	1027366-9
ISSN	1615-5947 ; 0890-5096
ISSN (online)	1615-5947
ISSN	0890-5096
DOI	10.1016/j.avsg.2016.02.013
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Zs.A 2882: Show issues

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Article ; Online: An agent-based model of vibration-induced intimal hyperplasia.

Reda, Maha / Noël, Christophe / Settembre, Nicla / Chambert, Jérôme / Lejeune, Arnaud / Rolin, Gwenae L / Jacquet, Emmanuelle

Biomechanics and modeling in mechanobiology

2022 Volume 21, Issue 5, Page(s) 1457–1481

Abstract: Acute exposure to hand-arm transmitted vibrations (HAVs) may decrease the wall shear stress (WSS) exerted by the blood flow on the arterial endothelium. In the case of chronic exposure to HAVs, these WSS changes can lead to arterial growth and remodeling ...

Abstract	Acute exposure to hand-arm transmitted vibrations (HAVs) may decrease the wall shear stress (WSS) exerted by the blood flow on the arterial endothelium. In the case of chronic exposure to HAVs, these WSS changes can lead to arterial growth and remodeling potentially induced by an intimal hyperplasia phenomenon. Accordingly, we implemented an agent-based model (ABM) that captures the hemodynamics-driven and mechanoregulated cellular mechanisms involved in vibration-induced intimal hyperplasia. Our ABM was combined with flow loop experiments that investigated the WSS-modulated secretion of the platelet-derived growth factor BB (PDGF-BB) by the endothelial cells. The ABM rules parameters were then identified and calibrated using our experimental findings and literature data. The model was able to replicate the basal state (no vibration) as well as predict a 30% stenosis resulting from a chronic drop of WSS values mimicking exposure to vibration during a timeframe of 10 years. The study of the influence of different WSS-modulated phenomena on the model showed that the magnitude of stenosis largely depends on the migratory effects of PDGF-BB and the mitogenic effects of Transforming Growth Factor [Formula: see text] on the Smooth Muscle Cells. The results also proved that the fall in circumferential stress due to arterial layer thickening to a great extent accounts for the degradation of the Extracellular Matrix in the media.
MeSH term(s)	Humans ; Tunica Intima/pathology ; Becaplermin ; Hyperplasia/pathology ; Endothelial Cells ; Constriction, Pathologic/pathology
Chemical Substances	Becaplermin (1B56C968OA)
Language	English
Publishing date	2022-07-19
Publishing country	Germany
Document type	Journal Article
ZDB-ID	2093052-5
ISSN	1617-7940 ; 1617-7959
ISSN (online)	1617-7940
ISSN	1617-7959
DOI	10.1007/s10237-022-01601-5
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Zs.A 5966: Show issues

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Article ; Online: Outcomes in the treatment of aberrant subclavian arteries using the hybrid approach.

Ben Ahmed, Sabrina / Settembre, Nicla / Touma, Joseph / Brouat, Anthony / Favre, Jean-Pierre / Jean Baptiste, Elixene / Chaufour, Xavier / Rosset, Eugenio

Interactive cardiovascular and thoracic surgery

2022 Volume 35, Issue 5

Abstract: Objectives: Aberrant subclavian artery (ASCA) occurs rarely but is one of the most frequent anatomical variations of the supra-aortic trunks. No consensus has been established on its best treatment. The goal of this study was to report the outcomes of ... ...

Abstract	Objectives: Aberrant subclavian artery (ASCA) occurs rarely but is one of the most frequent anatomical variations of the supra-aortic trunks. No consensus has been established on its best treatment. The goal of this study was to report the outcomes of ASCA treated by the hybrid approach. Methods: This non-interventional retrospective multicentre analysis included patients treated for ASCA by the hybrid approach in 12 French university hospitals between 2007 and 2019. The hybrid approach was defined as an endovascular procedure combined with open surgery or a hybrid stent graft. Patients were divided in 4 groups (from less to more complex treatment). The primary end point was 30-day mortality. The secondary end points were 30-day complications and late mortality. Results: This study included 43 patients. The mean age was 65 (SD, standard deviation: 16) years. Symptoms were found in 33 patients. Subclavian revascularization combined with aberrant subclavian artery occlusion was undertaken in 13 patients. Unilateral and bilateral subclavian revascularization combined with a thoracic aortic stent graft was undertaken in 11 and 6 patients, respectively. Total aortic arch repair combined with a thoracic aortic stent graft was undertaken in 13 patients. Thirty-day mortality was 2.3% with a technical success rate of 95.3%. The 30-day major postoperative complication rate was 16.3%: 4 strokes, 2 tamponades, 1 acute respiratory distress syndrome. Mean follow-up was 56.3 (SD: 44.7) months. The late mortality was 18.6%. Conclusions: The ASCA hybrid approach is feasible, safe and effective with low early mortality. Morbidity is rather high. However, it increases with the complexity of the hybrid approach, which should be kept as simple as possible if the anatomical morphology allows.
MeSH term(s)	Aged ; Aorta, Thoracic/surgery ; Aortic Aneurysm, Thoracic/surgery ; Blood Vessel Prosthesis Implantation/adverse effects ; Blood Vessel Prosthesis Implantation/methods ; Cardiovascular Abnormalities/surgery ; Endovascular Procedures/adverse effects ; Humans ; Retrospective Studies ; Subclavian Artery/abnormalities ; Subclavian Artery/diagnostic imaging ; Subclavian Artery/surgery ; Treatment Outcome
Language	English
Publishing date	2022-09-30
Publishing country	England
Document type	Journal Article ; Multicenter Study
ZDB-ID	2095298-3
ISSN	1569-9285 ; 1569-9293
ISSN (online)	1569-9285
ISSN	1569-9293
DOI	10.1093/icvts/ivac230
Database	MEDical Literature Analysis and Retrieval System OnLINE

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