Application of an extracorporeal prefenestrated stent graft in endovascular repair of ascending aorta and aortic arch lesions

Abstract

Objectives Aortic dissection involving the ascending aorta and aortic arch is a serious condition. Treatment using traditional surgical methods has certain disadvantages. This study investigated the effectiveness of thoracic endovascular repair of aortic dissection using an external prefenestrated stent. Methods We present a series of aortic dissection cases involving the ascending aorta and aortic arch treated with an external prefenestrated stent. Results Postoperative follow-up of the patients showed that all stents were released at the proper position and that branch vessels were not occluded, and there were no instances of type I endoleak. One patient died suddenly one week after surgery; another experienced retrograde type A aortic dissection in the second week; and type I endoleak occurred in one patient in the first week, although this resolved within six months. No serious complications such as cerebrovascular events, acute spinal cord ischemia, and paraplegia occurred during the perioperative period. All patients had false lumen thrombosis in the ascending aorta and aortic arch. Conclusion Prefenestrated stent grafting is a feasible treatment option for repairing an entry tear in the ascending aorta.

Endovascular Treatment of Type A Aortic Dissection: A Systematic Review and Meta-Analysis Using Reconstructed Time-to-Event Data

“…Even though there is no universally accepted operative technique, most centers favor the femoral artery for vascular access. Exceptions were noted by Wang et al [30], Ye et al [39], and Vallabhajosyula et al [41], who utilized the left brachial, left common carotid, and left subclavian arteries, respectively. Shah et al [50], also described the transapical method as an alternative for patients with unfavorable femoral anatomy.…”

“…In this statement, endovascular treatment of TAAD was not formally endorsed due to scarcity of high-quality cumulative data [8]. The present systematic review addresses this gap in the literature and constitutes the most comprehensive synopsis of TAAD management with TEVAR to date [26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45]. Herein, mean patient age at the time of intervention was 60.7 years.…”

Back-Table Modified Stent-Graft for Endovascular Repair of Ascending Aorta

“…All patients were treated in the chronic phase, and only 1 died. Wang et al 18 reported 9 patients who underwent TEVAR with the prefenestrated SG (double fenestration) for penetrating ulcers involving the ascending aorta or aortic arch. All stents were released at the proper position, and the branch vessels were not This cohort achieved a survival rate at 5 years of 68% and a free reintervention rate at 2 and 5 years of 75% and 64%, respectively.…”