{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T22:35:48Z","timestamp":1793399748562,"version":"4.5.0"},"reference-count":28,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2021,12,29]],"date-time":"2021-12-29T00:00:00Z","timestamp":1640736000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,5,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p\/>\n               <jats:sec>\n                  <jats:title>OBJECTIVES<\/jats:title>\n                  <jats:p>Our goal was to report outcomes of the endovascular repair of urgent thoracoabdominal aortic aneurysms (TAAAs) using the Cook Zenith t-Branch off-the-shelf multibranched endograft.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>Between 2010 and 2020, we collected patients with TAAAs who received an urgent endovascular repair using the Cook Zenith t-Branch (had a rupture, symptoms or diameter &amp;gt;80\u2009mm). Thirty-day mortality, spinal cord ischaemia (SCI) and clinical success were assessed as early outcomes. Freedom from reintervention, target visceral vessel patency and survival were considered during follow-up.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>Sixty-five cases were managed using the Cook Zenith t-Branch for 27 (42%) TAAA ruptures, 8 (12%) symptomatic TAAAs and 30 (46%) asymptomatic TAAAs with a diameter &amp;gt;80\u2009mm. Crawford\u2019s extent I\u2013II\u2013III and IV were noted in 54 (83%) and 11 (17%), respectively. Eleven (17%) patients had SCI with 3 (5%) cases of permanent paraplegia. Postoperative dialysis (P\u2009=\u20090.04) and ruptured TAAAs (P\u2009=\u20090.05) were associated with SCI. Sixteen (25%) patients had reinterventions within the first 30\u2009days postoperatively. The 30-day mortality was 14% (9). Ruptured TAAAs (P\u2009=\u20090.05) and technical failures (P\u2009=\u20090.01) were correlated with in-hospital mortality. Clinical success was 78% (51 patients). The mean follow-up was 18\u2009\u00b1\u200914\u2009months. Survival at 24\u2009months was 47% with no late TAAA-related deaths. Patients with ruptured TAAAs had lower survival than those who did not have ruptured TAAAs (52% vs 60% at 1\u2009year; P\u2009=\u20090.05). Target visceral vessel patency and freedom from reintervention at 24\u2009months were 89% and 60%, respectively.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>An off-the-shelf multibranched endograft is safe and effective for treating urgent TAAAs. Postoperative SCI and 30-day mortality are satisfactory for this challenging clinical scenario. The early reintervention rate is not negligible. Midterm survival is low, especially in patients with a ruptured TAAA; therefore, accurate patient selection is mandatory.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ejcts\/ezab553","type":"journal-article","created":{"date-parts":[[2021,12,18]],"date-time":"2021-12-18T12:07:45Z","timestamp":1639829265000},"page":"1087-1096","source":"Crossref","is-referenced-by-count":33,"title":["Urgent endovascular repair of thoracoabdominal aneurysms using an off-the-shelf multibranched endograft"],"prefix":"10.1093","volume":"61","author":[{"given":"Enrico","family":"Gallitto","sequence":"first","affiliation":[{"name":"Vascular Surgery, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, IRCCS Sant\u2019Orsola-Malpighi, 9th Massarenti Street, 40100, Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianluca","family":"Faggioli","sequence":"additional","affiliation":[{"name":"Vascular Surgery, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, IRCCS Sant\u2019Orsola-Malpighi, 9th Massarenti Street, 40100, Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Spath","sequence":"additional","affiliation":[{"name":"Vascular Surgery, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, IRCCS Sant\u2019Orsola-Malpighi, 9th Massarenti Street, 40100, Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodolfo","family":"Pini","sequence":"additional","affiliation":[{"name":"Vascular Surgery, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, IRCCS Sant\u2019Orsola-Malpighi, 9th Massarenti Street, 40100, Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1731-7808","authenticated-orcid":false,"given":"Chiara","family":"Mascoli","sequence":"additional","affiliation":[{"name":"Vascular Surgery, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, IRCCS Sant\u2019Orsola-Malpighi, 9th Massarenti Street, 40100, Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonino","family":"Logiacco","sequence":"additional","affiliation":[{"name":"Vascular Surgery, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, IRCCS Sant\u2019Orsola-Malpighi, 9th Massarenti Street, 40100, Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mauro","family":"Gargiulo","sequence":"additional","affiliation":[{"name":"Vascular Surgery, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, IRCCS Sant\u2019Orsola-Malpighi, 9th Massarenti Street, 40100, Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,12,29]]},"reference":[{"key":"2022050515421476700_ezab553-B1","doi-asserted-by":"crossref","first-page":"228","DOI":"10.23736\/S0021-9509.16.09796-2","article-title":"Treatment of acute thoracoabdominal aortic aneurysms","volume":"58","author":"Melissano","year":"2017","journal-title":"J Cardiovasc Surg"},{"key":"2022050515421476700_ezab553-B2","doi-asserted-by":"crossref","first-page":"996","DOI":"10.1016\/S1010-7940(96)80403-9","article-title":"Surgery for ruptured thoracic and thoraco-abdominal aortic aneurysms","volume":"10","author":"von Segesser","year":"1996","journal-title":"Eur J Cardiothorac Surg"},{"key":"2022050515421476700_ezab553-B3","doi-asserted-by":"crossref","first-page":"524","DOI":"10.1016\/j.ejvs.2014.11.018","article-title":"Editor's choice- ten-year experience with endovascular 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aneurysms","volume":"74","author":"Bertoglio","year":"2021","journal-title":"J Vasc Surg"},{"key":"2022050515421476700_ezab553-B9","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1016\/j.jvs.2019.08.273","article-title":"The risk of aneurysm rupture and target visceral vessel occlusion during the lead period of custom-made fenestrated\/branched endograft","volume":"72","author":"Gallitto","year":"2020","journal-title":"J Vasc Surg"},{"key":"2022050515421476700_ezab553-B10","doi-asserted-by":"crossref","first-page":"696","DOI":"10.1016\/j.jvs.2016.12.129","article-title":"Off-the shelf multibranched endograft for urgent endovascular repair of thoracoabdominal aortic aneurysms","volume":"66","author":"Gallitto","year":"2017","journal-title":"J Vasc Surg"},{"key":"2022050515421476700_ezab553-B11","doi-asserted-by":"crossref","first-page":"1817","DOI":"10.1016\/j.jvs.2021.05.041","article-title":"Early outcomes of the t-Branch off-the-shelf multi-branched stent graft in 542 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