Contralateral Carotid Occlusion With Sufficient Circle of Willis is not Associated With A Higher Incidence of Neurologic Events During Carotid Endarterectomy Without Shunting

Abstract

stent graft coverage (from the aortic arch to the iliac arteries) in terms of early-and mid-term clinical outcomes. Methods: A retrospective multicenter study was undertaken. All patients were treated with extensive endovascular aortic stent graft coverage with fenestrated/branched endografts at three experienced endovascular centers. Results: Between 2012 and 2017, 33 patients (22 males, 67%) were treated with a combination of fenestrated/ branched stentgrafts in the aortic arch and the thoracoabdominal aorta. Most of the patients (20/33,61%) had as a second stage procedure the fenestrated-branched endovascular repair of the thoraco-abdominal aorta (fb-EVAR) following the thoracic arch repair (fb-TEVAR), 10 had fb-TEVAR as first procedure, while 3 patients had a singlestage procedure. The mean age was 67AE13years, and the mean interval between procedures was 13AE12 months. For the fb-TEVAR 20 fenestrated and 13 branched devices were used, while for the fb-EVAR 23 fenestrated, 5 branched and 5 composite devices. The use of spinal drainage was more common in fb-EVAR (20/33,61%). Technical success was 100%. Mean hospital stay was 15AE13days for fb-TEVAR and 12AE9days for fb-EVAR. Two patients died in hospital after fb-EVAR, resulting in a 30-day mortality of 6%(2/33). No deaths occurred during the fb-TEVAR component or in the single-stage cases. Four patients developed spinal cord injury(12%); 1 permanent paraplegia(3%). Six patients (18%) died during a mean follow up of 23AE17months. The survival at 12 months after the second procedure was 72% and the freedom from any re-intervention was 82%.