Fenestrierte und verzweigte endovaskuläre Aortenprothesen

Dachs, Theresa-Marie; Hauck, Sven R; Kern, Maximilian; Klausenitz, Catharina; Funovics, Martin

doi:10.1007/s00117-022-01019-1

Cited by 4 publications

(2 citation statements)

References 29 publications

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“…This study demonstrates high technical success and comparable in-hospital, midterm, and long-term survival and re-intervention rates to classical fenestrated or outer-branched endografts for a mixed cohort of 44 patients treated with custom-made and off-the-shelf iBEVAR aortic prosthesis ( 11 , 13 , 15 , 21 , 22 ). This is currently one of the largest series on this relevant topic.…”

Section: Discussionmentioning

confidence: 71%

“…Although fenestrated and outer-branch aortic endografts have evolved to be applicable options for the treatment of thoracoabdominal aortic pathologies and complex AAAs, there are some specific limitations of the existing technology ( 11 , 13 , 21 ). So far, fenestrated endografts are preferred when aortic wall apposition is given at the origin of the visceral vessels.…”

Section: Discussionmentioning

confidence: 99%

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Single-center initial experience with inner-branch complex EVAR in 44 patients

Kapalla

Busch

Lutz

et al. 2023

Front. Cardiovasc. Med.

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PurposeThe use of inner-branch aortic stent grafts in the treatment of complex aortic pathologies aims at broad applicability and stable bridging stent sealing compared to other endovascular technologies. The objective of this study was to evaluate the early outcomes with a single manufacturer custom-made and off-the-shelf inner-branched endograft in a mixed patient cohort.MethodsThis retrospective, monocentric study between 2019 and 2022 included 44 patients treated with inner-branched aortic stent grafts (iBEVAR) as custom-made device (CMD) or off-the-shelf device (E-nside) with at least four inner branches. The primary endpoints were technical and clinical success.ResultsOverall, 77% (n = 34) and 23% (n = 10) of the patients (mean age 77 ± 6.5 years, n = 36 male) were treated with a custom-made iBEVAR with at least four inner branches and an off-the-shelf graft, respectively. Treatment indications were thoracoabdominal pathologies in 52.2% (n = 23), complex abdominal aneurysms in 25% (n = 11), and type Ia endoleaks in 22.7% (n = 10). Preoperative spinal catheter placement was performed in 27% (n = 12) of patients. Implantation was entirely percutaneous in 75% (n = 33). Technical success was 100%. Target vessel success manifested at 99% (178/180). There was no in-hospital mortality. Permanent paraplegia developed in 6.8% (n = 3) of patients. The mean follow-up was 12 months (range 0–52 months). Three late deaths (6.8%) occurred, one related to an aortic graft infection. Kaplan–Meier estimated 1-year survival manifested at 95% and branch patency at 98% (177/180). Re-intervention was necessary for a total of six patients (13.6%).ConclusionsInner-branch aortic stent grafts provide a feasible option for the treatment of complex aortic pathologies, both elective (custom-made) and urgent (off-the-shelf). The technical success rate is high with acceptable short-term outcomes and moderate re-intervention rates comparable to existing platforms. Further follow-up will evaluate long-term outcomes.

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