Aortic arch aneurysm repair with a new branched device

Piffaretti, Gabriele; Rivolta, Nicola; Fontana, Federico; Carrafiello, Gianpaolo; Mariscalco, Giovanni; Castelli, Patrizio

doi:10.1016/j.jvs.2012.10.080

Cited by 16 publications

(9 citation statements)

References 15 publications

(20 reference statements)

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“…Several branched arch repair techniques are in development, using devices that were custom-made with single or multiple side branches to accommodate the great vessels of the arch. 3,11 Currently, these devices are limited by their strict requirements of a healthy proximal landing zone, and initial reports of stroke have been a major concern. Although it is very possible that endovascular repair of arch aneurysms will become the main treatment modality for the elderly in the future, undue delay in providing treatment will invariably lead to further degenerative changes in the proximal and distal aorta, tortuosity, and thrombus formation, all factors detrimental to favorable surgical outcome.…”

Section: Discussionmentioning

confidence: 99%

Natural history and risk factors for rupture of thoracic aortic arch aneurysms

Yiu

Cheng

2016

Journal of Vascular Surgery

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Section: Discussionmentioning

confidence: 99%

Natural history and risk factors for rupture of thoracic aortic arch aneurysms

Yiu

Cheng

2016

Journal of Vascular Surgery

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“…Some studies have reported favorable results using fenestrated/branched techniques in aortic arch pathologies. [3][4][5][6][7] However, this approach is limited by the morphological diversity of the aortic arch, necessitating patient-specific and tailor-made devices. Moreover, the procedures are complex and time-consuming, often inapplicable in emergency situations, and place a considerable financial burden on the patient, limiting their clinical usefulness.…”

Section: Introductionmentioning

confidence: 99%

Thoracic Endovascular Aortic Repair With Single/Double Chimney Technique for Aortic Arch Pathologies

Wang

Shu

et al. 2017

J Endovasc Ther

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Purpose: To summarize a single-center experience using the single/double chimney technique in association with thoracic endovascular aortic repairs (TEVAR) for aortic arch pathologies. Methods: From November 2007 to March 2016, 122 patients (mean age 50.4±12.7 years, range 29-80; 92 men) with aortic arch pathologies underwent TEVAR combined with single (n=101) or double (n=21) chimney grafts to reconstruct the supra-aortic branches: 21 innominate arteries, 114 left common carotid arteries, and 8 left subclavian arteries (LSA). Pathologies included type B aortic dissection (n=47), aortic arch dissection (n=49), retrograde type A aortic dissection (n=8), thoracic aortic aneurysm (n=7), penetrating aortic arch ulcer (n=9), and post-TEVAR type I endoleak (n=2). Follow-up examinations included computed tomography at 0.5, 3, 6, and 12 months and yearly thereafter. Results: The aortic stent-grafts were deployed in zone 0 (n=21), zone 1 (n=93), and zone 2 (n=8). One (0.8%) of the 122 patients died at 4 days due to a perforated peptic ulcer. Type Ia endoleaks were found intraoperatively in 13 (10.7%) patients, including 3 with the double chimney technique. Type II endoleaks occurred in 6 (4.9%) patients; 3 were treated with duct occluders in the LSA. Postoperative chimney graft migration occurred in 1 (0.8%) patient with double chimneys; additional stent-grafts were deployed in both chimneys. Median follow-up was 32.3 months, during which 1 (0.8%) patient died after a stroke at 3 months. Chimney stent-graft patency was observed in the remaining 120 patients. Two (1.7%) secondary TEVARs were performed for distal aortic dissection. Nine asymptomatic type Ia endoleaks and 1 type II endoleak persisted in follow-up; a type II endoleak in 1 patient with Marfan syndrome sealed in 52 months. Conclusion: TEVAR with the chimney technique provides a safe, minimally invasive alternative with good chimney graft patency and low postoperative mortality during midterm follow-up. The double chimney technique should be used judiciously owing to its potential complications.

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“…Nevertheless, relatively recently there have been increasing reports on the development and use of branched endografts for aortic arch pathology involving arch vessels with promising early results. 2,4,12 This technique offers a potential alternative treatment option for patients with aortic pathology involving the aortic arch especially in those who are not fit for open surgery. However, further research and long-term outcome data are required.…”

Section: Discussionmentioning

confidence: 99%

Two-Vessel Branched Stent Graft for Severely Angulated Aortic Arch Aneurysm in a Jehovah’s Witness

Lim

Dhutia

Riga

et al. 2018

Vasc Endovascular Surg

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Aneurysmal disease involving the origins of supra aortic vessels often requires complex open and/or endovascular repair that is not only associated with significant risk of mortality and morbidity but also often with perioperative blood loss requiring transfusion. We report a successful repair of a large thoracic aortic aneurysm (TAA) involving the aortic arch with a custom-made Bolton Relay 2-vessel branched thoracic aortic endograft in a 42-year-old Jehovah's Witness who would otherwise be very unlikely to survive an open repair. Branched thoracic aortic endografting offers a potentially safe, minimally invasive, and effective alternative for TAA disease involving the supra-aortic arteries, especially in patients who are at high risk of open surgery.

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Aortic arch aneurysm repair with a new branched device

Cited by 16 publications

References 15 publications

Natural history and risk factors for rupture of thoracic aortic arch aneurysms

Natural history and risk factors for rupture of thoracic aortic arch aneurysms

Thoracic Endovascular Aortic Repair With Single/Double Chimney Technique for Aortic Arch Pathologies

Two-Vessel Branched Stent Graft for Severely Angulated Aortic Arch Aneurysm in a Jehovah’s Witness

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