Results of complex aortic stent grafting of XXXX stratified according to the proximal landing zone using the Society for Vascular Surgery classification.

@entity1 @entity1593 @entity190 @entity439 @entity204 @entity1028
BACKGROUND: Advances in endovascular technology have led to the successful treatment of @entity1028 . However, there is currently no consensus on what constitutes a @entity439 . There is emerging evidence that the extent of the @entity439 is associated with outcome. We compare the outcomes of 150 consecutive @entity1 treated with a fenestrated or branched stent graft and present the data stratified according to the Society for Vascular Surgery classification based on proximal anatomic landing zones. METHODS: A prospectively collected database of consecutive @entity1 undergoing fenestrated or branched stent graft insertion in a tertiary center between 2008 and 2013 was retrospectively analyzed. @entity439 were subdivided into zones according to where the area of proximal seal could be achieved in relation to the visceral arteries. Zone 8 covers the renal arteries, zone 7 covers the superior mesenteric artery, and zone 6 covers the @entity1593 . @entity1 demographics, operative variables, mortality, and major morbidity were analyzed by univariate and multivariate analysis to assess for differences between zones. RESULTS: During the study period, 150 @entity1 were treated. There were 49 in zone 8, 76 in zone 7, and 25 in zone 6. Prior aortic surgery had been performed in 19 @entity1 , which included 11 @entity1 with previous @entity439 repairs. There was significantly increased @entity190 (P < .001), operative time (P < .0001), total hospital stay (P = .018), and intensive care unit stay (P < .0001) as the zones ascended the aorta. There were 14 inpatient @entity204 recorded across all zones with a 30-day mortality rate of 8%. Logistic regression analysis for 30 day mortality showed a significant increase as the zones ascended (P = .007). Kaplan-Meier analysis showed that 5-year survival significantly deteriorated as the zones ascended (P = .039), with no significant difference in the freedom from reintervention curves between zones (P = .37). CONCLUSIONS: We have shown that the extent of the @entity439 as determined by the proximal sealing zone is associated with outcome. Mortality, operative duration, @entity190 , and hospital stay all significantly increased as the zones ascended. These data also validate the use of the proposed new classification based on aortic anatomy.
