Application of an extracorporeal prefenestrated stent graft in endovascular repair of ascending aorta and aortic arch lesions

Vascular. 2021 Jun;29(3):323-329. doi: 10.1177/1708538120950876. Epub 2020 Sep 14.

Abstract

Objectives: Aortic dissection involving the ascending aorta and aortic arch is a serious condition. Treatment using traditional surgical methods has certain disadvantages. This study investigated the effectiveness of thoracic endovascular repair of aortic dissection using an external prefenestrated stent.

Methods: We present a series of aortic dissection cases involving the ascending aorta and aortic arch treated with an external prefenestrated stent.

Results: Postoperative follow-up of the patients showed that all stents were released at the proper position and that branch vessels were not occluded, and there were no instances of type I endoleak. One patient died suddenly one week after surgery; another experienced retrograde type A aortic dissection in the second week; and type I endoleak occurred in one patient in the first week, although this resolved within six months. No serious complications such as cerebrovascular events, acute spinal cord ischemia, and paraplegia occurred during the perioperative period. All patients had false lumen thrombosis in the ascending aorta and aortic arch.

Conclusion: Prefenestrated stent grafting is a feasible treatment option for repairing an entry tear in the ascending aorta.

Keywords: Aortic dissection; penetrating ulcer; prefenestration; thoracic endovascular aortic repair.

MeSH terms

  • Adult
  • Aged
  • Aorta, Thoracic / diagnostic imaging
  • Aorta, Thoracic / surgery*
  • Aortic Aneurysm, Thoracic / diagnostic imaging
  • Aortic Aneurysm, Thoracic / surgery*
  • Aortic Dissection / diagnostic imaging
  • Aortic Dissection / surgery*
  • Blood Vessel Prosthesis Implantation / adverse effects
  • Blood Vessel Prosthesis Implantation / instrumentation*
  • Blood Vessel Prosthesis*
  • Endovascular Procedures / adverse effects
  • Endovascular Procedures / instrumentation*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Postoperative Complications / etiology
  • Prosthesis Design
  • Stents*
  • Time Factors
  • Treatment Outcome
  • Ulcer / diagnostic imaging
  • Ulcer / surgery*