Gabriele Piffaretti1, Martin Czerny2, Vicente Riambau3, Roman Gottardi4, Thomas Wolfgruber4,5, Chris Probst6, Peter Matt7, Michele Antonello8, Gino Gerosa8, Mohamad Hamady9, Federico Fontana10, Sandro Ferrarese1,11, Chiara Lomazzi12, Viviana Grassi12, Sebastian Fernandez-Alonso13, Santi Trimarchi12,14. 1. Vascular Surgery-Department of Medicine and Surgery, ASST Settelaghi University Teaching Hospital, University of Insubria School of Medicine, Varese, Italy. 2. Department of Cardiovascular Surgery, Faculty of Medicine, Heart Centre Freiburg University, University of Freiburg, Freiburg, Germany. 3. Vascular Surgery Division, Cardiovascular Institute, Hospital Clinic University of Barcelona, Barcelona, Spain. 4. Department of Cardiac Surgery, Paracelsus Medical University, Salzburg, Austria. 5. Department of Radiology, Paracelsus Medical University, Salzburg, Austria. 6. Department of Cardiac Surgery, University of Bonn, Bonn, Germany. 7. Department of Cardiac Surgery, Herzzentrum Luzern, Luzern, Switzerland. 8. Vascular and Cardiac Surgery-Department of Cardiac, Thoracic and Vascular Sciences, University of Padua School of Medicine, Padua, Italy. 9. Interventional Radiology-Department of Surgery and Cancer, St Mary's Hospital Imperial College Healthcare NHS Trust, London, United Kingdom. 10. Interventional Radiology-Department of Medicine and Surgery, ASST Settelaghi University Teaching Hospital, University of Insubria School of Medicine, Varese, Italy. 11. Cardiac Surgery-Department of Medicine and Surgery, ASST Settelaghi University Teaching Hospital, University of Insubria School of Medicine, Varese, Italy. 12. Vascular Surgery, Fondazione IRCCS Cà Granda, Milan, Italy. 13. Vascular Surgery, Complejo Hospitalairo of Navarra, Pamplona, Spain. 14. Department of Clinical and Community Sciences, Ospedale Maggiore Policlinico, Milan, Italy.
Abstract
OBJECTIVES: The aim of this article is to report the mid-term results of ascending thoracic endovascular aortic repair using a custom-made device (CMD). METHODS: This was a retrospective study performed at tertiary centres. Nine patients considered unfit for open surgery received elective total endovascular repair of the ascending aorta with a Relay® (Terumo Aortic, Sunrise; FL, USA) CMD: pseudoaneurysn (n = 5), localized dissection (n =3) and contained rupture (n = 1). RESULTS: Primary clinical success was achieved in all patients with no major complications and no early conversion to open surgery. All patients were discharged home and independent: median length of stay was 7 days (interquartile range, 6-18). No patient was lost to follow-up at a median 26 months (interquartile range, 12-36). Three patients died 2, 6 and 24 months after intervention; 1 was aorta related (late aorto-atrial fistula due to infection that required open surgery). At the last follow-up available, no endoleaks, migrations, fractures or ruptures were observed in the remaining 6 patients. CONCLUSIONS: Ascending thoracic endovascular aortic repair with Terumo Aortic CMDs was technically feasible, effective and safe in very selected lesions. CMDs showed good ascending aorta conformability with different configurations and diameters, and satisfactory mid-term durability as shown by both structural integrity and aortic lesion exclusion.
OBJECTIVES: The aim of this article is to report the mid-term results of ascending thoracic endovascular aortic repair using a custom-made device (CMD). METHODS: This was a retrospective study performed at tertiary centres. Nine patients considered unfit for open surgery received elective total endovascular repair of the ascending aorta with a Relay® (Terumo Aortic, Sunrise; FL, USA) CMD: pseudoaneurysn (n = 5), localized dissection (n =3) and contained rupture (n = 1). RESULTS: Primary clinical success was achieved in all patients with no major complications and no early conversion to open surgery. All patients were discharged home and independent: median length of stay was 7 days (interquartile range, 6-18). No patient was lost to follow-up at a median 26 months (interquartile range, 12-36). Three patients died 2, 6 and 24 months after intervention; 1 was aorta related (late aorto-atrial fistula due to infection that required open surgery). At the last follow-up available, no endoleaks, migrations, fractures or ruptures were observed in the remaining 6 patients. CONCLUSIONS: Ascending thoracic endovascular aortic repair with Terumo Aortic CMDs was technically feasible, effective and safe in very selected lesions. CMDs showed good ascending aorta conformability with different configurations and diameters, and satisfactory mid-term durability as shown by both structural integrity and aortic lesion exclusion.
Authors: Sven R Hauck; Alexander Kupferthaler; Marlies Stelzmüller; Wolf Eilenberg; Marek Ehrlich; Christoph Neumayer; Florian Wolf; Christian Loewe; Martin A Funovics Journal: Cardiovasc Intervent Radiol Date: 2021-06-27 Impact factor: 2.740