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Outcomes of bridging stent grafts in fenestrated and branched endovascular aortic repair.

Authors
  • Torsello, Giovanni Federico1
  • Beropoulis, Efthymios2
  • Munaò, Roberta3
  • Trimarchi, Santi4
  • Torsello, Giovanni B2
  • Austermann, Martin2
  • 1 Department of Diagnostic and Interventional Radiology and Nuclear Medicine, Charité Campus Virchow-Klinikum, Charité University Medicine Berlin, Berlin, Germany; Department of Vascular Surgery, St. Franziskus Hospital Münster, Münster, Germany. Electronic address: [email protected] , (Germany)
  • 2 Department of Vascular Surgery, St. Franziskus Hospital Münster, Münster, Germany. , (Germany)
  • 3 Department of Vascular Surgery, St. Franziskus Hospital Münster, Münster, Germany; Department of Clinical and Community Sciences, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico Milan, University of Milan, Milan, Italy. , (Germany)
  • 4 Department of Clinical and Community Sciences, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico Milan, University of Milan, Milan, Italy. , (Italy)
Type
Published Article
Journal
Journal of vascular surgery
Publication Date
Sep 01, 2020
Volume
72
Issue
3
Pages
859–865
Identifiers
DOI: 10.1016/j.jvs.2019.10.089
PMID: 31964573
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Until today, no dedicated bridging stent graft (BSG) has been available for use in fenestrated and branched endovascular aneurysm repair (F/BEVAR). The purpose of this study was to evaluate the clinical performance of the well-known Advanta/iCast V12 (Getinge Maquet, Rastatt, Germany) and the new Viabahn VBX (W. L. Gore & Associates, Flagstaff, Ariz) balloon-expandable stent graft in F/BEVAR. Retrospective analysis of prospectively collected data was performed. Inclusion criteria were treatment with fenestrated or branched endografts for complex aortic diseases, implantation of at least one VBX stent graft as a BSG in one of the target vessels, and clinical or radiologic follow-up of 6 months. The primary end point of the study was technical success of all BSGs, defined as placement of the BSG in the desired position with absence of endoleak on final angiography. Secondary end points were freedom from perioperative major adverse events and freedom from reinterventions and mortality at 6 months. Procedural and postoperative data were analyzed. Between December 2017 and July 2018, there were 50 patients (40 male; mean age, 71 years) included. A total of 145 VBX stent grafts were implanted, followed by 57 Advanta V12, 29 Viabahn, and 28 bare-metal stents. There were 126 branches (celiac trunk, 27; superior mesenteric artery, 25; renal arteries, 74) sealed exclusively with VBX. Technical success rate was 98.6%. There were six device-related reinterventions due to type IC endoleaks (n = 4), target vessel stenosis distal to the BSG, and stent graft occlusion in a left renal artery in one case. The perioperative and aneurysm-related mortality was 0%; the 6-month all-cause mortality was 2%. The used BSGs demonstrated promising preliminary results in F/BEVAR. Further evaluation is mandatory to determine durability of the VBX. Copyright © 2019 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

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