Abstract：
To report our experience applying endovascular stent graft repair to treat ascending aortic diseases in high-risk patients and to evaluate the safety and feasibility of this approach. Patients with comorbid conditions or older age are not suitable for open procedures but may be considered suitable for ascending endovascular repair. Eleven high-risk patients received zone 0 thoracic endovascular aortic repair from September 2014 to May 2020. All patients were followed up until death or December 2021. Primary outcomes were in-hospital and long-term all-cause mortality as well as in-hospital and long-term aorta-related mortality. The mean follow-up duration of all patients was 35.78 months. The cohort comprised of three pathology subgroups: penetrating atherosclerotic ulcer (PAU) (n =6), acute dissection (AD) (n = 3), and chronic dissecting aneurysm (CDA) (n = 2). The in-hospital all-cause mortality rates were 0%, 33.33% and 0% for PAU, AD, and CDA groups, respectively. Long-term all-cause mortality were 33.33%, 33.33%, and 50% for PAU, AD, and CDA groups, respectively. There was only one in-hospital death related to acute aortic dissection, and no long-term aorta-related deaths occurred during the study period. During the follow-up time, the majority of patients had good remodeling of ascending aorta, slow progression in cases with endoleak, and no aorta-related mortality. Ascending endovascular aortic repair appears to be a safe and feasible procedure for emergent aortic repair in carefully selected patients with prohibitive surgical risk who are not candidates for open procedures.
摘要：
报告我们在高危患者中应用血管内支架修复术治疗升主动脉疾病的经验，并评估该方法的安全性和可行性。患有合并症或年龄较大的患者不适合进行开放手术，但可能被认为适合进行上行血管内修复。2014年9月至2020年5月，11例高危患者接受了0区胸主动脉腔内修复术。所有患者均接受随访，直至死亡或2021年12月。主要结果是住院和长期全因死亡率以及住院和长期主动脉相关死亡率。所有患者的平均随访时间为35.78个月。该队列包括三个病理亚组：穿透性动脉粥样硬化性溃疡（PAU）（n=6），急性夹层（AD）（n=3），和慢性夹层动脉瘤（CDA）（n=2）。住院全因死亡率为0%,PAU为33.33%和0%，AD,和CDA组，分别。长期全因死亡率为33.33%,33.33%,和50%的PAU，AD,和CDA组，分别。只有一例院内死亡与急性主动脉夹层有关，研究期间未发生长期主动脉相关死亡.在随访期间,大多数患者升主动脉重塑良好，内漏病例进展缓慢，无主动脉相关死亡率。对于精心选择的具有过高手术风险且不适合进行开放手术的患者，上行腔内主动脉修复术似乎是紧急主动脉修复的安全可行方法。
