Midterm outcomes of in situ fenestration for aortic arch vessels

Abstract

Objective To evaluate midterm outcomes of thoracic endovascular aortic repair (TEVAR) with in situ fenestration(ISF) to revascularize the aortic arch vessels. Methods From Feb 2012 to Dec 2014, 10 patients underwent TEVAR with aortic arch vessels revascularized via ISF.There were 6 patients of thoracic aortic aneurysms (TAA) and 4 of type B aortic dissection (TBAD). Patients were followed for all-cause mortality, endoleak of post-TEVAR, integrity and patency of aortic endograft and branch vessels. Results Totally 11 branch vessels [10 left subclavian arteries (LSA), 1 left common carotid artery (LCA)] via ISF were revascularized in 10 patients.Patients were followed-up for 24-55 mouths, mean of 42.80 months. 1 TAA patient died in 2 years post-TEVAR unrelated to the operation. All fenestrations remained patent, and there were no endoleaks and no occlusion, compression, or fracture of stents. There were no postoperative strokes and left upper limbs ischemia.1 patient had distal aortic endograft pseudoaneurysms formation in 2 years post-TEVAR and underwent reTEVAR treatment. Conclusion Aortic arch vessels revascularization via ISF in TEVAR is safe and feasible. Midterm outcomes is satisfactory. Key words: Aortic diseases; Angioplasty; In situ fenestration; Common carotid artery; Left subclavian artery