Midterm outcomes of fenestrated TEVAR using physician-modified endovascular grafts for zone 2

Bi, Jiaxue; Niu, Fang; Li, Peng; Dai, Xiangchen; Zhu, Jiechang; Liu, Zongwei

doi:10.1177/17085381211019611

Cited by 4 publications

(1 citation statement)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…5 Commonly, OAR is reserved only for those fit patients in experienced highvolume centres and TEVAR arises as the best treatment for those anatomically suitable. 6 Many techniques have been described to achieve adequate proximal/distal landing zones (PLZ/DLZ); as scallops, 7 chimneys, 8,9 in-situ laser fenestration, 10 endograft modifications, 11 branched repair, 12 fenestrated repair 13 and hybrid procedures associating cervical supra-aortic debranching. These approaches are critical to optimising the length of the LZ in order to minimise the risk of type I endoleaks (T1ELs).…”

Section: Introductionmentioning

confidence: 99%

Mid-term outcomes of the use of endoanchors during thoracic endovascular aortic repair in multicentre analysis

et al. 2022

View full text Add to dashboard Cite

Objective To describe mid-term outcomes of the use of EndoAnchors as an adjunct for arch and thoracic endovascular aortic repair (TEVAR). Methods A retrospective multicentre series from nine centres using the Heli-FX EndoAnchor System (Medtronic Inc, Minneapolis, USA) at TEVAR over May 2014–May 2019 is presented. The study is registered at ClinicalTrials.gov with number NCT04100499. The primary outcome was freedom from Type I endoleak at EndoAnchors deployments; secondary outcomes included evaluation of aortic wall penetration (AWP) at first computed tomography scan, EndoAnchor-related issues and mortality. Results 54 high-risk patients (35 males/19 females, age 73 ± 11 years) with arch, thoracic and thoracoabdominal aneurysmal disease (3 chronic post-dissection and one patch pseudoaneurysm), with a mean neck length 19.7 ± 6.6 mm that were treated with multiple hybrid and endovascular techniques were included. A total of 329 EndoAnchors were used with a mean of 6.1 ± 2.5 per patient. Overall adequate AWP was 86%, whereas arch (Ishimaru’s zones 0–2) deployments achieved 80.6% when compared to 87.3% in descending thoracic aorta (dTA); although there was no statistical significance. Freedom from type I endoleaks was 88% at 2 year follow-up, due to 4 type IA endoleaks, two of them successfully treated, one with conservative treatment due to complexity of repair and remaining patient died 1 year later due to endograft infection. There were reported five EndoAnchor-related issues; four losses and one renal stent-graft was crushed due to catheter deflection solved with balloon reinflation. None of the losses had clinical significance. Overall mortality is described for 7 (9.5%) patients, one of them aneurysm-related. Conclusions The adjunctive use of EndoAnchors in TEVAR and complex TEVAR procedures achieved acceptable outcomes at midterm in a high-risk series with hostile seal zones. Still, they should be still judiciously used as there is lack of data to suggest a more liberal use; therefore, the landing zone should not be compromised in favour of their use.

show abstract

Section: Introductionmentioning

confidence: 99%

Mid-term outcomes of the use of endoanchors during thoracic endovascular aortic repair in multicentre analysis

et al. 2022

View full text Add to dashboard Cite

show abstract

Comparison of Chimney and Fenestrated Techniques for Supra-Aortic Branch Revascularization During Thoracic Endovascular Aortic Repair: A Systematic Review and Meta-Analysis

Liu,

Wu,

et al. 2023

Cardiovasc Intervent Radiol

View full text Add to dashboard Cite

Efficacy of Endovascular Repair Using Single Left Common Carotid Artery Stent Combined with Castor Single-Branched Stent-Graft in the Treatment of Regional Diseases of Zone 2 of the Aorta

Fang,

Tian,

Chen

et al. 2024

J Endovasc Ther

View full text Add to dashboard Cite

Purpose: To observe the short-term efficacy of thoracic endovascular aortic repair (TEVAR) using a single left common carotid artery chimney stent combined with a Castor single-branched stent-graft (SC-TEVAR) in the treatment of zone 2 (Z2) aortic diseases. Materials and Methods: To conduct a retrospective analysis of 20 patients with Z2 aortic diseases who were treated in our department from June 2021 to April 2022. The lesions included true aortic degenerative aneurysms with diameter ≥5.0 cm and penetrating aortic ulcers with depth >1.0 cm or basal width >2.0 cm. All 20 patients accepted the SC-TEVAR treatment, which was a new hybrid method to assure the flow of the left common carotid artery (LCCA) and left subclavian artery (LSA). This method was defined as a concomitant chimney stent for LCCA and a Castor single-branched stent graft for the aorta and LSA. The baseline data and intraoperative data were collected to evaluate the safety and efficacy of this method. The patency of the target blood vessel and any associated complications were evaluated at 1 and 6 months postoperatively, to analyze the safety and efficacy of this new method. Results: After discharge from the hospital, all patients were followed up by a specific follow-up team. At 6 monthly follow-up period, there were no cardiac events, stroke, hemiplegia, type I endoleak, type II endoleak, proximal stent graft-induced new entries, distal stent graft-induced new entries, wound infection, or bleeding. Only 1 patient developed an inguinal wound hematoma and got conservative treatment. Importantly, no patients developed stenosis or occlusion of the LCCA or LSA. The patency of branched arteries was 100%. The technical success rate was 90%. Conclusion: SC-TEVAR appears to be a new and relatively simple, safe, and effective treatment for Z2 aortic diseases. Clinical Impact This was a single-center retrospective cohort study. A total of 20 patients with zone 2 aortic diseases accepted a new hybrid surgical method named SC-TEVAR. This method was not complicated and could be finished with only 3 peripheral artery exposure. The result showed no mortality, 100% patency of the branch artery, and 90% of technical success in 6 months of follow-up time. SC-TEVAR showed a satisfactory result in this retrospective study and could be promoted as an easy method to treat zone 2 aortic diseases.

show abstract

Midterm outcomes of fenestrated TEVAR using physician-modified endovascular grafts for zone 2

Cited by 4 publications

References 22 publications

Mid-term outcomes of the use of endoanchors during thoracic endovascular aortic repair in multicentre analysis

Mid-term outcomes of the use of endoanchors during thoracic endovascular aortic repair in multicentre analysis

Comparison of Chimney and Fenestrated Techniques for Supra-Aortic Branch Revascularization During Thoracic Endovascular Aortic Repair: A Systematic Review and Meta-Analysis

Efficacy of Endovascular Repair Using Single Left Common Carotid Artery Stent Combined with Castor Single-Branched Stent-Graft in the Treatment of Regional Diseases of Zone 2 of the Aorta

Contact Info

Product

Resources

About