On table fenestrated stent graft in zone 0 and zone 1 for aortic arch diseases

Abstract

Objective To evaluate fenestrated thoracic endovascular aortic repair (f-TEVAR) using fenestrated stent graft on table in zone 0 and zone 1 for aortic arch diseases. Methods 13 patients undergoing f-TEVAR by using physician modified fenestrated stent grafts (PMSGs) on table in zone 0 and zone 1 for aortic arch diseases between Nov 2015 and Mar 2018 were retrospectively reviewed. Results The median age was 59 years(range, 33-81 years). PMSGs were deployed from Z0 in 5 patients and Z1 in remaining 8 patients. All but 3 patients underwent elective procedure. The technical success rate was 92.3%. Overall mortality was 7.7% (1/13). There were no perioperative neurologic complications and paraplegia. One patient suffering from acute left leg ischemia and renal failure recovered after open embolectomy and dialysis. Median length of stay was 9.0 days (range, 4-35 days). 12 patients were survival at a median follow-up of 11.5 months (range, 1.0-19.0 months). Retrograde dissection occurred in one patient and resolved after open repair. During follow up, all target vessels remained patent, with no fenestration-related type Ⅰ or Ⅲ endoleaks. Conclusions f-TEVAR using modified fenestrated stent grafts on table in Z0 and Z1 is feasible for the treatment of aortic arch diseases. Key words: Aortic diseases; Angioplasty; Fenestrated stent-graft