scholarly journals Thoracic Endovascular Repair for Aortic Arch Pathologies with Surgeon Modified Fenestrated Stent Grafts: A Multicentre Retrospective Study

2021 ◽  
Vol 74 (6) ◽  
pp. 2117-2118
Author(s):  
X. Li ◽  
W. Li ◽  
X. Dai ◽  
W. Li ◽  
J. Zhang ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Aortic Arch ◽  
Endovascular Repair ◽  
Stent Grafts ◽  
Thoracic Endovascular Repair ◽  
Multicentre Retrospective Study

Long-Term Outcomes of Thoracic Endovascular Repair for Aortic Arch Dissection Using Customized Single-Branched Fenestrated Stent-Graft

2021 ◽  
pp. 153857442110104
Author(s):  
Xiaoye Li ◽  
Lei Zhang ◽  
Chao Song ◽  
Hao Zhang ◽  
Shibo Xia ◽  
...  
Keyword(s):  
Aortic Arch ◽  
Stent Graft ◽  
Endovascular Repair ◽  
Artery Occlusion ◽  
Stent Grafts ◽  
Technical Success Rate ◽  
Thoracic Endovascular Repair ◽  
Subclavian Artery Occlusion ◽  
Fenestrated Stent Graft

Objectives: To report outcomes of thoracic endovascular repair using customized single-branched fenestrated stent-grafts in treatment of aortic arch dissections. Materials and Methods: Between November 2009 and November 2011, 16 patients with aortic arch dissections underwent thoracic endovascular aortic repair utilizing customized unibody single-branched fenestrated stent-graft (UBFSG) in our institution. Results: All 16 patients were male with mean age of 54.50 ± 11.33. The technical success rate was 100%. 30-day mortality rate was 6.25% (n = 1). The median follow-up period was 98 months (range, 0-119). During follow-up, 4 nonaorta-related deaths were recorded. Two (2) cases of left subclavian artery occlusion were observed 12 and 14 months after the operation. Two (2) patients had another successful endovascular repair in time, including one case of type Ib endoleak occurred 100 months after the operation and one case of stent-graft induced new entry tear 38 months after the operation. No stroke and migration of stent-grafts were observed. Conclusions: The branched fenestrated stent-graft may be an effective alternative treatment for aortic arch dissections unfit for open surgery.

scholarly journals Anatomic Suitability for Branched Thoracic Endovascular Repair in Patients with Aortic Arch Pathological Features

2020 ◽  
Vol 9 (20) ◽  
Author(s):  
Stefan P.M. Smorenburg ◽  
Matthew Montesano ◽  
Tijs J. Hoogteijling ◽  
Maarten Truijers ◽  
Petr Symersky ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Aortic Arch ◽  
Endovascular Repair ◽  
Computed Tomography Angiography ◽  
Open Surgery ◽  
High Volume ◽  
Pathological Features ◽  
Type B ◽  
Thoracic Endovascular Repair ◽  
Thoracic Aneurysms

Background Endovascular repair has become a viable alternative for aortic pathological features, including those located within the aortic arch. We investigated the anatomic suitability for branched thoracic endovascular repair in patients previously treated with conventional open surgery for aortic arch pathological features. Methods and Results Patients who underwent open surgery for aortic arch pathological features at our institution between 2000 and 2018 were included. Anatomic suitability was determined by strict compliance with the anatomic criteria within manufacturers’ instructions for use for each of the following branched thoracic stent grafts: Relay Plus Double‐Branched (Terumo‐Aortic), TAG Thoracic Branch Endoprosthesis (W.L. Gore & Associates), Zenith Arch Branched Device (Cook‐Medical), and Nexus Stent Graft System (Endospan Ltd/Jotec GmbH). Computed tomography angiography images were analyzed with outer luminal line measurements. A total of 377 patients (mean age, 64±14 years; 64% men) were identified, 153 of whom had suitable computed tomography angiography images for measurements. In total, 59 patients (15.6% of the total cohort and 38.6% of the measured cohort) were eligible for endovascular repair using at least one of the devices. Device suitability was 30.9% for thoracic aneurysms, 4.6% for type A dissections, 62.5% for type B dissections, and 28.6% for other pathological features. Conclusions The anatomic suitability for endovascular repair of all aortic arch pathological features was modest. The highest suitability rates were observed for thoracic aneurysms and for type B dissections, of which repair included part of the aortic arch. We suggest endovascular repair of arch pathological features should be reserved for high‐volume centers with experience in endovascular arch repair.

scholarly journals Biomechanical implications of excessive endograft protrusion into the aortic arch after thoracic endovascular repair

2015 ◽  
Vol 66 ◽  
pp. 235-241 ◽  
Author(s):  
Antonino Rinaudo ◽  
Giuseppe Maria Raffa ◽  
Francesco Scardulla ◽  
Michele Pilato ◽  
Cesare Scardulla ◽  
...  
Keyword(s):  
Aortic Arch ◽  
Endovascular Repair ◽  
Thoracic Endovascular Repair

Pre-fenestration endovascular repair of aortic diseases in patients with zone 2 segment: A single-center experience

Vascular ◽  
2020 ◽  
pp. 170853812097987
Author(s):  
Yu-Jing Zhang ◽  
Lei Bai ◽  
Liang Wang ◽  
Hong-Rui Shi ◽  
Jiang-Long Liu ◽  
...  
Keyword(s):  
Aortic Arch ◽  
Stent Graft ◽  
Endovascular Repair ◽  
Aortic Rupture ◽  
Type I ◽  
Aortic Diseases ◽  
Technical Success Rate ◽  
Thoracic Endovascular Repair ◽  
Aortic Lesions

Objective The present study aims to analyze the outcomes of three cases of pre-fenestration and branch stent-graft endovascular repair of aortic disease with zone 2 aortic lesions. Methods From August 2017 to June 2018, three patients with zone 2 aortic lesions underwent thoracic endovascular repair with innominate artery, left common carotid artery, and left subclavian artery recannulation using pre-fenestration and branched stent-grafts to preserve the patency of the aortic arch branches. Results The technical success rate was 100%. One patient had a proximal type I endoleak with no need for additional treatment. The overall mortality was 0%. All branches were patent. The follow-up period lasted for 2–15 months, with one patient lost to follow-up. There were no conversions to open surgical repair, aortic rupture, paraplegia, or retrograde type A aortic dissection. Conclusion The use of a pre-fenestration and branch stent-graft for the thoracic endovascular repair of zone 2 aortic lesions is a feasible and effective method for aortic arch branch revascularization. The risk of this surgical procedure is high, requiring significant expertise. The procedure should be conducted only in experienced centers. Durability concerns should be assessed in future studies with long-term follow-up.

Homemade Fenestrated Stent-Grafts for Complete Endovascular Repair of Aortic Arch Dissections

2019 ◽  
Vol 26 (5) ◽  
pp. 645-651 ◽  
Author(s):  
Ludovic Canaud ◽  
Baris Ata Ozdemir ◽  
Lucien Chassin-Trubert ◽  
Julien Sfeir ◽  
Pierre Alric ◽  
...  
Keyword(s):  
Aortic Arch ◽  
Stent Graft ◽  
Endovascular Repair ◽  
Covered Stent ◽  
Type I ◽  
Type Ii ◽  
Stent Grafts ◽  
Fenestrated Stent Graft ◽  
Type I Endoleak

Purpose: To evaluate outcomes of homemade fenestrated stent-grafts for complete endovascular aortic repair of aortic arch dissections. Materials and Methods: From July 2014 through September 2018, 35 patients (mean age 66±11 years; 25 men) underwent homemade fenestrated stent-graft repair of acute (n=16) or chronic (n=10) complicated type B aortic dissections (n=16) and dissecting aortic arch aneurysms subsequent to surgical treatment of acute type A dissections (n=9). Nineteen (54%) procedures were emergent. Results: Zone 2 single-fenestrated stent-grafts were used in 25 cases; the remaining 10 were double-fenestrated stent-grafts deployed in zone 0. Median time for stent-graft modification was 18 minutes (range 16–20). Technical success was achieved in all cases. An immediate distal type I endoleak was treated intraoperatively. Among the double-fenestrated stent-graft cases, the left subclavian artery fenestration could not be cannulated in 2 patients and revascularization was required. Partial coverage of the left common carotid artery necessitated placement of a covered stent in 3 cases. One (3%) patient had a stroke without permanent sequelae. Two type II endoleaks required additional covered stent placement at 5 and 7 days postoperatively, respectively. The 30-day mortality was 6% (2 patients with ruptured aortic arch aneurysm). During a mean follow-up of 17.6±13 months, there was no aortic rupture or retrograde dissection. One late type I endoleak was treated with additional proximal fenestrated stent-graft placement. One type II endoleak is currently under observation. One additional patient died (unrelated to the aorta); overall mortality was 9%. All supra-aortic trunks were patent. Conclusion: The use of homemade fenestrated stent-grafts for endovascular repair of aortic arch dissections is feasible and effective for total endovascular aortic arch repair. Durability concerns will need to be assessed in additional studies with long-term follow-up.

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