Anatomical feasibility of an endovascular aortic arch repair with the NEXUS endograft in patients treated with a frozen elephant trunk procedure for aortic arch pathology
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 preopera...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
SpringerOpen
2023-03-01
|
| Series: | CVIR Endovascular |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s42155-023-00355-0 |
| _version_ | 1797863476379516928 |
|---|---|
| author | Ward Exelmans Hozan Mufty Geert Maleux Peter Verbrugghe Inge Fourneau |
| author_facet | Ward Exelmans Hozan Mufty Geert Maleux Peter Verbrugghe Inge Fourneau |
| author_sort | Ward Exelmans |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-04-09T22:36:11Z |
| format | Article |
| id | doaj.art-8dcd6d1b262c416b93cdd7f70de84410 |
| institution | Directory Open Access Journal |
| issn | 2520-8934 |
| language | English |
| last_indexed | 2024-04-09T22:36:11Z |
| publishDate | 2023-03-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | CVIR Endovascular |
| spelling | doaj.art-8dcd6d1b262c416b93cdd7f70de844102023-03-22T12:28:58ZengSpringerOpenCVIR Endovascular2520-89342023-03-01611610.1186/s42155-023-00355-0Anatomical feasibility of an endovascular aortic arch repair with the NEXUS endograft in patients treated with a frozen elephant trunk procedure for aortic arch pathologyWard Exelmans0Hozan Mufty1Geert Maleux2Peter Verbrugghe3Inge Fourneau4Department of Vascular Surgery, University Hospitals LeuvenDepartment of Vascular Surgery, University Hospitals LeuvenDepartment of Radiology, University Hospitals LeuvenDepartment of Cardiac Surgery, University Hospitals LeuvenDepartment of Vascular Surgery, University Hospitals LeuvenAbstract 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.https://doi.org/10.1186/s42155-023-00355-0Aortic archAortic stent graftEndovascular repairAnatomic feasibility |
| spellingShingle | Ward Exelmans Hozan Mufty Geert Maleux Peter Verbrugghe Inge Fourneau Anatomical feasibility of an endovascular aortic arch repair with the NEXUS endograft in patients treated with a frozen elephant trunk procedure for aortic arch pathology CVIR Endovascular Aortic arch Aortic stent graft Endovascular repair Anatomic feasibility |
| title | Anatomical feasibility of an endovascular aortic arch repair with the NEXUS endograft in patients treated with a frozen elephant trunk procedure for aortic arch pathology |
| title_full | Anatomical feasibility of an endovascular aortic arch repair with the NEXUS endograft in patients treated with a frozen elephant trunk procedure for aortic arch pathology |
| title_fullStr | Anatomical feasibility of an endovascular aortic arch repair with the NEXUS endograft in patients treated with a frozen elephant trunk procedure for aortic arch pathology |
| title_full_unstemmed | Anatomical feasibility of an endovascular aortic arch repair with the NEXUS endograft in patients treated with a frozen elephant trunk procedure for aortic arch pathology |
| title_short | Anatomical feasibility of an endovascular aortic arch repair with the NEXUS endograft in patients treated with a frozen elephant trunk procedure for aortic arch pathology |
| title_sort | anatomical feasibility of an endovascular aortic arch repair with the nexus endograft in patients treated with a frozen elephant trunk procedure for aortic arch pathology |
| topic | Aortic arch Aortic stent graft Endovascular repair Anatomic feasibility |
| url | https://doi.org/10.1186/s42155-023-00355-0 |
| work_keys_str_mv | AT wardexelmans anatomicalfeasibilityofanendovascularaorticarchrepairwiththenexusendograftinpatientstreatedwithafrozenelephanttrunkprocedureforaorticarchpathology AT hozanmufty anatomicalfeasibilityofanendovascularaorticarchrepairwiththenexusendograftinpatientstreatedwithafrozenelephanttrunkprocedureforaorticarchpathology AT geertmaleux anatomicalfeasibilityofanendovascularaorticarchrepairwiththenexusendograftinpatientstreatedwithafrozenelephanttrunkprocedureforaorticarchpathology AT peterverbrugghe anatomicalfeasibilityofanendovascularaorticarchrepairwiththenexusendograftinpatientstreatedwithafrozenelephanttrunkprocedureforaorticarchpathology AT ingefourneau anatomicalfeasibilityofanendovascularaorticarchrepairwiththenexusendograftinpatientstreatedwithafrozenelephanttrunkprocedureforaorticarchpathology |