Pre-fenestration endovascular repair of aortic diseases in patients with zone 2 segment: A single-center experience

Zhou, Yujing; Bai, Lijun; Wang, Liang; Shi, Hongrui; Liu, Jianglong; Ma, Fu-Zhen; Guo, Shouwu; Li, Xiaodong

doi:10.1177/1708538120979874

Cited by 2 publications

(2 citation statements)

References 17 publications

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“…However, 1 major downside is that modifying the stent during surgery can lead to a higher risk of infection and a greater likelihood of postoperative type III endoleak. [8] In this case study, we employed a novel prefenestration technique to reconstruct the left subclavian artery of a patient with aortic dissection. Our approach involved creating a small prefenestration within the aortic coated stent and guiding a wire through the stent from the left brachial artery, circumventing the need for external fenestration.…”

Section: Discussionmentioning

confidence: 99%

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A novel wire-guided prefenestration technique for patients with type B aortic dissection: A case report

Ge,

2024

Medicine

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Rationale: Acute type B aortic dissection (ABAD) is a fatal and severe cardiovascular disease. There are various strategies for dissection involving the left subclavian artery, but limited by the variety and cost of stents, the treatment brings certain obstacles. The aim of this study is to evaluate the effectiveness and safety of the wire-guided prefenestration technique for treating left subclavian artery involvement in patients with arterial dissection. Patient concerns: A 48-year-old man was transferred to our hospital due to persistent chest and back pain that had lasted for 6 hours. Diagnoses: Preoperative computed tomography angiogram (CTA) of the thoracic and abdominal aorta diagnosed with ABAD that affected his left subclavian artery, who needed emergency endovascular treatment due to malperfusion of the lower limb arteries. Interventions: To perform the procedure, a guide wire was inserted through the left brachial artery, exited through the right femoral artery, and then entered the pre-fenestrated hole leading to the main stent. The stent was released while the guide wire was in position, and the left subclavian artery was reconstructed using viabahn. Outcomes: Thoracic endovascular aortic repair was successfully completed for ABAD. A follow-up CT angiogram of the thoracic and abdominal aorta revealed positive vascular remodeling and no signs of significant internal leakage after one month. Lessons: This innovative approach offers a secure and efficient treatment option for aortic dissection in individuals who have undergone left subclavian artery reconstruction.

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Section: Discussionmentioning

confidence: 99%

“…However, 1 major downside is that modifying the stent during surgery can lead to a higher risk of infection and a greater likelihood of postoperative type III endoleak. [ 8 ]…”

Section: Discussionmentioning

confidence: 99%

A novel wire-guided prefenestration technique for patients with type B aortic dissection: A case report

Ge,

2024

Medicine

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Efficacy of Endovascular Repair Using Single Left Common Carotid Artery Stent Combined with Castor Single-Branched Stent-Graft in the Treatment of Regional Diseases of Zone 2 of the Aorta

Fang,

Tian,

Chen

et al. 2024

J Endovasc Ther

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Purpose: To observe the short-term efficacy of thoracic endovascular aortic repair (TEVAR) using a single left common carotid artery chimney stent combined with a Castor single-branched stent-graft (SC-TEVAR) in the treatment of zone 2 (Z2) aortic diseases. Materials and Methods: To conduct a retrospective analysis of 20 patients with Z2 aortic diseases who were treated in our department from June 2021 to April 2022. The lesions included true aortic degenerative aneurysms with diameter ≥5.0 cm and penetrating aortic ulcers with depth >1.0 cm or basal width >2.0 cm. All 20 patients accepted the SC-TEVAR treatment, which was a new hybrid method to assure the flow of the left common carotid artery (LCCA) and left subclavian artery (LSA). This method was defined as a concomitant chimney stent for LCCA and a Castor single-branched stent graft for the aorta and LSA. The baseline data and intraoperative data were collected to evaluate the safety and efficacy of this method. The patency of the target blood vessel and any associated complications were evaluated at 1 and 6 months postoperatively, to analyze the safety and efficacy of this new method. Results: After discharge from the hospital, all patients were followed up by a specific follow-up team. At 6 monthly follow-up period, there were no cardiac events, stroke, hemiplegia, type I endoleak, type II endoleak, proximal stent graft-induced new entries, distal stent graft-induced new entries, wound infection, or bleeding. Only 1 patient developed an inguinal wound hematoma and got conservative treatment. Importantly, no patients developed stenosis or occlusion of the LCCA or LSA. The patency of branched arteries was 100%. The technical success rate was 90%. Conclusion: SC-TEVAR appears to be a new and relatively simple, safe, and effective treatment for Z2 aortic diseases. Clinical Impact This was a single-center retrospective cohort study. A total of 20 patients with zone 2 aortic diseases accepted a new hybrid surgical method named SC-TEVAR. This method was not complicated and could be finished with only 3 peripheral artery exposure. The result showed no mortality, 100% patency of the branch artery, and 90% of technical success in 6 months of follow-up time. SC-TEVAR showed a satisfactory result in this retrospective study and could be promoted as an easy method to treat zone 2 aortic diseases.

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Pre-fenestration endovascular repair of aortic diseases in patients with zone 2 segment: A single-center experience

Cited by 2 publications

References 17 publications

A novel wire-guided prefenestration technique for patients with type B aortic dissection: A case report

A novel wire-guided prefenestration technique for patients with type B aortic dissection: A case report

Efficacy of Endovascular Repair Using Single Left Common Carotid Artery Stent Combined with Castor Single-Branched Stent-Graft in the Treatment of Regional Diseases of Zone 2 of the Aorta

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