Abstract
Abstract
Background
The aim of this study was to evaluate the feasibility of an endovascular repair, using the NEXUS™ Aortic Arch Stent Graft System, in a real-world cohort of patients, treated with a Frozen Elephant Trunk (FET) procedure for pathology involving the aortic arch.
Results
The preoperative computed tomography angiography scans of 37 patients were retrospectively analyzed using a dedicated workstation. In total, seven patients (N = 7/37; 18.9%) were eligible for endovascular repair. This number increased to eleven patients (N = 11/37; 29.7%) if an additional relining of the distal aorta would be performed. Device suitability was 47.1% in patients (N = 8/17; 47.1%) with aortic arch aneurysm, 12.5% (N = 1/8; 12.5%) in patients with an acute Stanford type A dissection and 50% (N = 2/4; 50%) in patients with Crawford type II thoraco-abdominal aneurysm. The stent graft was not suitable for any of the two patients with chronic type B dissection (N = 0/2; 0%). In 22 patients (N = 22/37; 59.5%) an endovascular repair with this type of stent graft was not feasible due to an inadequate proximal sealing zone. There was no suitable brachiocephalic trunk landing zone in 13 patients (N = 13/37; 35.1%). There was no suitable distal landing zone distal in 14 patients (N = 14/37; 36.8%). This number decreased to ten patients (N = 10/37; 27.0%) when considering an additional relining of the distal aorta.
Conclusions
Endovascular repair with the NEXUS single branch stent graft is feasible in a minority of this real-world cohort that underwent a Frozen Elephant Trunk procedure. However, the applicability of this device probably improves in cases with isolated aortic arch aneurysms.
Publisher
Springer Science and Business Media LLC
Subject
Cardiology and Cardiovascular Medicine,Radiology, Nuclear Medicine and imaging
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