Total endovascular aortic arch repair using the Terumo Aortic triple-branch arch endograft

Objective: To evaluate the feasibility and outcomes of total endovascular repair of aortic arch aneurysms using a novel triple-branch arch endograft. Methods: Retrospective review of the clinical data and outcomes of 3 patients with arch aneurysms treated at a single institution using a custom-made triple-branch aortic endograft (Terumo Aortic, Sunrise, FL) between 2015 and 2020. The device has 3 internal branches corresponding to the principal branches of the standard aortic arch, obviating the need for any surgical revascularization. This initial experience represents the first three cases ever performed in the world using this endograft. Results: All procedures were technically successful. There were no strokes, in-hospital, or 1 year mortality. All 3 patients required secondary re-interventions. One patient died 14 months after the index procedure due to endocarditis unrelated to the arch repair. Conclusion: The initial experience with the Terumo Aortic triple-branch endograft for treatment aortic arch aneurysms showed that, while the procedure is technically feasible, there remain significant anatomic and mechanical challenges in the endovascular repair of this segment of the thoracic aorta. Further refinements of endograft design and identification of optimal bridging stent technology are needed.

Automated summary

The study evaluated the feasibility and outcomes of total endovascular repair of aortic arch aneurysms using a novel triple-branch arch endograft. While technically successful, there are significant anatomic and mechanical challenges that require further refinements in endograft design and optimal bridging stent technology.