Journal
EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY
Volume 60, Issue 3, Pages 662-668Publisher
OXFORD UNIV PRESS INC
DOI: 10.1093/ejcts/ezab160
Keywords
Aortic arch; Thoracic endovascular aortic repair; Endovascular aortic repair
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The study aimed to evaluate the results of endovascular aortic arch repair using the Relay Branch system, showing a high technical success rate, acceptable in-hospital mortality, but non-disabling stroke remains a major concern. Patients with residual aortic dissection have the best prognosis, and more data are needed to support these findings.
OBJECTIVES: Our goal was to evaluate results of endovascular aortic arch repair using the Relay Branch system. METHODS: Forty-three patients with thoracic aortic pathology involving the aortic arch have been treated with the Relay Branch system (Terumo Aortic, Sunrise, FL, USA) in 10 centres. We assessed in-hospital mortality, neurological injury, treatment success according to current reporting standards and the need for secondary interventions. In addition, outcome was analysed according to the underlying pathology: non-dissective disease versus residual aortic dissection (RAD) (defined as remaining dissection after previous type A repair, chronic type B aortic dissections). RESULTS: In-hospital mortality was 9% (0% in patients with RAD). Disabling stroke occurred in 7% (0% in patients with RAD); non-disabling stroke occurred in 19% (7% in patients with RAD). Early type IA and B endoleak formation occurred in 4%. Median follow-up was 1618months. During the follow-up period, 23% of the patients died. Aortic-related deaths were low (3% in patients with RAD). CONCLUSIONS: The results of endovascular aortic arch repair using the Relay Branch system in a selected patient population with regard to technical success are good. In-hospital mortality is acceptable, the number of disabling strokes is low and technical success is high. Non-disabling stroke is a major concern, and every effort has to be taken to reduce this to a minimum. The best outcome is seen in patients with underlying RAD. Finally, more data are needed.
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