| Outcomes of endovascular repair of aortic arch disease with multiple parallel stent grafts |
| Received:January 23, 2022 Revised:March 24, 2022 Click here to download the full text |
| Citation of this paper:GUO Bao-lei,FU Wei-guo,GUO Da-qiao,XU Xin,CHEN Bin,SHI Zhen-yu,DONG Zhi-hui,YAN Cheng.Outcomes of endovascular repair of aortic arch disease with multiple parallel stent grafts[J].Chinese Journal of Clinical Medicine,2022,29(3):377-382 |
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| Author Name | Affiliation | E-mail | | GUO Bao-lei | Department of Vascular Surgery, Zhongshan Hospital, Fudan University, National Clinical Research Center for Interventional Medicine, Shanghai 200032, China
Fudan Zhangjiang Institute, Shanghai 201203, China | | | FU Wei-guo | Department of Vascular Surgery, Zhongshan Hospital, Fudan University, National Clinical Research Center for Interventional Medicine, Shanghai 200032, China | fu.weiguo@zs-hospital.sh.cn | | GUO Da-qiao | Department of Vascular Surgery, Zhongshan Hospital, Fudan University, National Clinical Research Center for Interventional Medicine, Shanghai 200032, China | | | XU Xin | Department of Vascular Surgery, Zhongshan Hospital, Fudan University, National Clinical Research Center for Interventional Medicine, Shanghai 200032, China | | | CHEN Bin | Department of Vascular Surgery, Zhongshan Hospital, Fudan University, National Clinical Research Center for Interventional Medicine, Shanghai 200032, China | | | SHI Zhen-yu | Department of Vascular Surgery, Zhongshan Hospital, Fudan University, National Clinical Research Center for Interventional Medicine, Shanghai 200032, China | | | DONG Zhi-hui | Department of Vascular Surgery, Zhongshan Hospital, Fudan University, National Clinical Research Center for Interventional Medicine, Shanghai 200032, China | | | YAN Cheng | Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai 200032, China | |
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| Abstract:Objective To explore the early and midterm outcomes of treating aortic arch disease with multiple parallel stent grafts (MPSGs) in patients deemed high risk for open surgery. Methods To analyze the clinical data of 27 patients with aortic arch diseases treated by multiple parallel stents combined with thoracic aortic endovascular repair in the Department of Vascular Surgery of Zhongshan Hospital, Fudan University from February 2011 to August 2018. Results A total of 27 patients (mean age,[50.8±10.1] years; 20 men) underwent TEVAR with MPSGs. Pathologies included thoracic aortic aneurysm (n=10), type B aortic dissection with retrograde dissection (n=7), post-TEVAR type Ⅰ endoleak (n=4), aortic arch dissected aneurysm postsurgical repair (n=3), and anastomotic pseudoaneurysm (n=3). Seventeen and ten patients had disease in aortic arch zone 0 and 1, respectively. Technical success was achieved in all patients. Intraoperative type Ⅰ endoleak was observed in 10 patients (37.0%). No major morbidity or mortality occurred perioperatively. The median follow-up duration was 24.2 months (range, 3-92), during which time 3 patients required an aortic-related reintervention. The overall mortality rate was 11.1% (3/27). The estimated 2- and 4-year survival rates were 92.4% ±5.6% and 83.2% ±11.7%, respectively. The estimated rates of freedom from endoleak at 2 and 4 years were 84.4% ±9.4% and 75.9% ±14.1%, respectively. Conclusions TEVAR with MPSGs is feasible for the treatment of aortic arch disease in high-risk patients unsuitable for open surgery. Additional evidence and studies with larger sample size and longer follow-up are required to standardize this technique and support its durability. |
| keywords:aneurysm aortic dissection parallel stent endovascular repair |
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