Physician Modified Fenestrated Endografts for Endovascular Aortic Arch Repair in Zone 0.
Eur J Vasc Endovasc Surg
; 68(2): 190-199, 2024 Aug.
Article
em En
| MEDLINE
| ID: mdl-38641315
ABSTRACT
OBJECTIVE:
This multicentre study aimed to assess the early and midterm outcomes of physician modified fenestrated endografts (PMEGs) for endovascular aortic arch repair in zone 0.METHODS:
Between 2018 and 2022, a retrospective study was conducted in three centres of consecutive patients undergoing endovascular aortic arch repair in zone 0 with PMEGs. Endpoints included technical success, 30 day mortality rate, major adverse events, secondary interventions, stent stability, target vessel patency, and overall survival.RESULTS:
A total of 54 patients (mean age 63 years; 45 males) with aortic arch pathology were included, comprising aortic dissections (n = 32; 59%) and aortic arch aneurysms (n = 22; 41%). Technical success was 98%. One patient died from stroke within 30 days. Major adverse events included stroke (n = 4; 7%), retrograde type A dissection (RTAD) (n = 3; 6%), and acute kidney injury (n = 2; 4%). During a median follow up of 12 months, there were two deaths (4%) of unknown cause at one month and 1.5 months, and no aortic related death. Type Ia, type Ic, and type IIIc endoleaks were observed in two (4%), three (6%), and two (4%) patients, respectively. No vessel stenosis was observed. Re-intervention was required in 10 patients (19%). Estimates of overall survival, freedom from secondary intervention, and freedom from target vessel instability at one year were 94.2% (standard error [SE] 3.3%), 81.8% (SE 6.0%), and 92.0% (SE 4.5%), respectively.CONCLUSION:
This study has demonstrated the efficacy of PMEGs for zone 0 endovascular aortic arch repair, with acceptable technical success and mortality rates. Stroke, RTAD, and re-intervention rates remain a concern for endovascular therapy. A larger population and long term outcomes are required to assess the safety and durability of this technique as a beneficial choice for endovascular aortic arch repair in specialised centres.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Aorta Torácica
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Desenho de Prótese
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Prótese Vascular
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Stents
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Aneurisma da Aorta Torácica
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Implante de Prótese Vascular
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Procedimentos Endovasculares
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Dissecção Aórtica
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article