Handmade fenestrated stent grafts to preserve all supra-aortic branches in thoracic endovascular aortic repair.
J Thorac Cardiovasc Surg
; 160(3): 629-639.e1, 2020 09.
Article
em En
| MEDLINE
| ID: mdl-31564542
ABSTRACT
OBJECTIVE:
To evaluate the efficacy and safety of a zone 0 landing aortic stent graft with handmade fenestrations for the preservation of all supra-aortic branches in thoracic endovascular aortic repair (TEVAR).METHODS:
This study included 13 consecutive patients who underwent TEVAR using zone 0 landing handmade fenestrated stent grafts to preserve all supra-aortic branches from July 2016 to April 2017. Technical success was defined as the resolution of the primary aortic pathology as well as the preservation of all supra-aortic branches through the accurate alignment of the fenestration. Outcomes including technical success, perioperative morbidity and mortality, requirement of secondary interventions, and graft patency were analyzed.RESULTS:
In this study, 11 patients presented with aortic dissection, 1 presented with thoracic aortic aneurysm with impending rupture, and 1 presented with penetrating aortic ulcer of the thoracic aorta. The technical success rate of the primary procedure was 100%. Over a mean follow-up of 20 months, secondary endovascular procedures were performed in 6 patients to resolve 3 cases of stent graft-induced new entry, 2 cases of type Ib endoleak, and 1 case of new false lumen formation. During the study period, no complication resulting from proximal landing and fenestration occurred.CONCLUSIONS:
Our experience of using handmade fenestrated stent grafts revealed preliminary results of using the grafts to preserve all supra-aortic branches in TEVAR, and results demonstrated the feasibility of this technique for achieving total arch replacement endovascularly in selective patients. Further technical advancement is anticipated, and larger studies with long-term follow-up are required.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Aneurisma da Aorta Torácica
/
Implante de Prótese Vascular
/
Procedimentos Endovasculares
Tipo de estudo:
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
Limite:
Humans
Idioma:
En
Ano de publicação:
2020
Tipo de documento:
Article