A Novel Vascular-Friendly Thoracic Stent Graft for Endovascular Repair of Acute Complicated Type B Aortic Dissection

Abstract

high mortality and morbidity rates. 1,2) In recent years, multiple consensus statements have recommended thoracic endovascular aortic repair (TEVAR) as the treatment of choice for ac-TBAD. 3,4) Evidence-based medicine has shown that TEVAR can significantly reduce early mortality and improve the prognosis. [5][6][7] Endovascular treatment for acTBAD, however, is still associated with major complications such as retrograde type A dissection (RTAD), 8,9) stent-graft migration, 10) distal true lumen collapse, 11) endoleaks, 12) and stent-graft-induced new entry. 13) Most current aortic stent grafts are designed for patients with chronic degenerative diseases such as an aortic aneurysm. Studies have revealed that complications are closely related to stent characteristics, such as the size of the graft, design of a proximal barbed shape, and the radial strength of stent. 14) Here, we introduce a novel vascular-friendly thoracic stent graft, the Ankura Thoracic Stent Graft Purpose: To evaluate the safety and efficacy of a novel vascular-friendly thoracic stent graft for patients with acute complicated type B aortic dissection (ac-TBAD). Methods: A multicenter retrospective study was undertaken in which we prospectively collected data in consecutive ac-TBAD patients treated by thoracic endovascular aortic repair (TEVAR) with the Ankura Thoracic Stent. Complications, true lumen rate (TLR), and mortality were recorded. Follow-up computed tomography angiography (CTA) was performed at 1, 6, and 12 months postoperatively and yearly thereafter. Results: Altogether, 63 patients with ac-TBAD in four medical centers were included. No deaths or serious complications occurred during the perioperative period. The mean follow-up time was 30.1 ± 18.9 months. All-cause mortality rate was 3.1% (n = 2). TEVAR-related mortality rate was 1.6% (n = 1) because of retrograde type A dissection (RTAD) at 6 months. The other death was caused by acute myocardial infarction (AMI) during the third postoperative month. A distal endoleak detected at 3 months in one patient (1.6%) was treated by reintervention. The use of this novel vascular-friendly thoracic stent graft in ac-TBAD postoperative patients significantly improved their TLR. Conclusion: The novel vascular-friendly thoracic stent graft showed satisfactory results, with favorable stability of the aortic diameter during follow-up.