Avoiding Stroke in Patients Undergoing Endovascular Aortic Arch Repair JACC Review Topic of the Week

Article Surgery

NEXUS Arch: A Multicenter Study Evaluating the Initial Experience With a Novel Aortic Arch Stent Graft System

David Planer et al.

Summary: This study assessed the initial clinical experience with a novel endograft system designed for aortic arch pathologies. The results demonstrate that the system has a high success rate and excellent safety and performance at 1 year.

ANNALS OF SURGERY (2023)

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Article Surgery

Anemia is associated with higher mortality and morbidity after thoracic endovascular aortic repair

Kanhua Yin et al.

Summary: Using a national vascular surgery database, this study found that moderate to severe anemia is associated with increased mortality, postoperative complications, and worse 1-year survival after TEVAR.

JOURNAL OF VASCULAR SURGERY (2023)

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Review Cardiac & Cardiovascular Systems

A Systematic Review of Total Endovascular Aortic Arch Repair: A Promising Technology

Ameen M. Basha et al.

Summary: TEAAR is an emerging alternative for the treatment of aortic arch disease in high-risk patients. A systematic review of TEAAR was conducted to evaluate its early outcomes. The study found that TEAAR is mainly indicated for chronic arch dissection with degenerative aneurysmal disease and pure arch aneurysm.

CANADIAN JOURNAL OF CARDIOLOGY (2023)

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Article Cardiac & Cardiovascular Systems

Identifying risk factors for early neurological outcomes following thoracic endovascular aortic repair using the SUMMIT database

Nikolaos Tsilimparis et al.

Summary: Acute TBAD and prolonged procedure time increase the risk of early stroke, while the deployment of more endografts, older age, and preoperative renal impairment increase the risk of early paraplegia or paraparesis. Placement of endografts proximal to the left subclavian artery (LSA) increases stroke risk for acute TBAD.

EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY (2022)

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Article Surgery

Comparison of the Outcomes of Total Endovascular Aortic Arch Repair Between Branched Endograft and Chimney Endograft Technique in Zone 0 Landing

Tomoaki Kudo et al.

Summary: This study compared the outcomes of total endovascular aortic arch repair between bTEVAR and cTEVAR in LZ 0, finding no cases of conversion to open repair within 30 days for both methods, but a higher rate of type 1a endoleak in cTEVAR. Strict preoperative evaluation to prevent stroke is necessary, considering the high risk factors identified in the study.

JOURNAL OF ENDOVASCULAR THERAPY (2022)

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Article Cardiac & Cardiovascular Systems

Outcomes of thoracic endovascular aortic repair for penetrating aortic ulcers involving the left subclavian artery with the Castor single-branched stent graft

Ben Huang et al.

Summary: This study evaluated the effectiveness and safety of using the Castor single-branched stent graft to treat penetrating aortic ulcers (PAUs) involving the left subclavian artery.

EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY (2022)

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Review Surgery

Systematic Review on Customized and Non-customized Device Techniques for the Endovascular Repair of the Aortic Arch

Petroula Nana et al.

Summary: This study evaluates the outcomes of available endovascular techniques for aortic arch pathology management. The results show that endovascular repair is a feasible alternative for high-risk patients. The technical success rate is generally high, with acceptable early mortality. However, cerebrovascular events remain a concern and further advancements are needed.

JOURNAL OF ENDOVASCULAR THERAPY (2022)

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Article Surgery

Outcomes of endovascular repair of aortic aneurysms with the GORE thoracic branch endoprosthesis for left subclavian artery preservation

Michael D. Dake et al.

Summary: This study recruited 84 patients with zone 2 aneurysms across 34 investigative sites for a nonrandomized, prospective study of a single branched aortic endograft. The results demonstrated that this endovascular procedure had good safety and efficacy outcomes up to 12 months, with low mortality and reintervention rates, and an acceptable frequency of procedural complications.

JOURNAL OF VASCULAR SURGERY (2022)

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Article Surgery

Homemade fenestrated physician-modified stent grafts for arch aortic degenerative aneurysms

Robin Chastant et al.

Summary: This study evaluated the early and medium-term outcomes of single and double fenestrated physician-modified endovascular grafts for degenerative aortic arch aneurysm repair. The results showed that this new technique had good performance in terms of preoperative background, procedural success rate, and postoperative complications.

JOURNAL OF VASCULAR SURGERY (2022)

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Article Cardiac & Cardiovascular Systems

Favorable neurological outcomes in thoracic endovascular aortic repair with RELAY™ branched-An international perspective

Sven Z. C. P. Tan et al.

Summary: The data presented in this study demonstrates that RELAY(TM) Branched is associated with favorable neurological outcomes and excellent technical success rates. Key design features of the endoprosthesis and good perioperative management play an important role in mitigating neurological complications following endovascular aortic arch repair.

JOURNAL OF CARDIAC SURGERY (2022)

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Article Cardiac & Cardiovascular Systems

2022 ACC/AHA Guideline for the Diagnosis and Management of Aortic Disease

Eric M. Isselbacher et al.

Summary: The 2022 ACC/AHA Guideline provides comprehensive recommendations for the diagnosis and management of aortic disease, emphasizing the importance of shared decision making and multidisciplinary team expertise.

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY (2022)

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Article Medicine, General & Internal

Cerebral Embolic Protection during Transcatheter Aortic-Valve Replacement

Samir R. R. Kapadia et al.

Summary: Among patients with aortic stenosis undergoing transfemoral TAVR, the use of CEP did not have a significant effect on the incidence of periprocedural stroke, but on the basis of the 95% confidence interval around this outcome, the results may not rule out a benefit of CEP during TAVR.

NEW ENGLAND JOURNAL OF MEDICINE (2022)

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Article Surgery

Endovascular Treatment of Post Type A Chronic Aortic Arch Dissection With a Branched Endograft Early Results From a Retrospective International Multicenter Study

Dorian Verscheure et al.

Summary: This study evaluated the outcomes of endovascular aortic arch repair for chronic dissection with a custom-made branched endograft, showing low mortality and stroke rates but a high reintervention rate. Further follow-up is needed to confirm the benefits of this novel approach.

ANNALS OF SURGERY (2021)

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Article Surgery

Endovascular Repair of Aortic Arch Aneurysm with a New Modular Double Inner Branch Stent Graft

Wei Guo et al.

Summary: Endovascular repair of aortic arch aneurysm has advanced significantly in the past decade, with promising results from custom-made branched stent grafts. A new off-the-shelf modular double inner branch stent-graft system has shown to be safe and feasible for patients unfit for traditional surgery.

ANNALS OF VASCULAR SURGERY (2021)

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Article Surgery

Silent Brain Infarction After Endovascular Arch Procedures: Preliminary Results from the STEP Registry

Philippe Charbonneau et al.

Summary: This study aimed to quantify the rate of silent brain infarctions following endovascular treatment of the aortic arch. Results showed that these infarctions were frequent, especially in patients with more severe aortic diseases.

EUROPEAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY (2021)

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Article Surgery

Pre-Loaded Fenestrated Thoracic Endografts for Distal Aortic Arch Pathologies: Multicentre Retrospective Analysis of Short and Mid Term Outcomes

Nikolaos Tsilimparis et al.

Summary: This multicentre study demonstrates the feasibility of treating distal aortic arch pathologies with pre-loaded fenestrated thoracic endograft (f-TEVAR), showing promising outcomes in terms of 30 day mortality, stroke, and spinal cord ischemia rates. Despite high technical success, intraoperative wire entanglement remains a challenge, and endoleaks were observed during follow up, leading to decreased long-term survival and freedom from re-intervention rates.

EUROPEAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY (2021)

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Article Cardiac & Cardiovascular Systems

Outcomes of single physician-modified fenestrated stent grafts for endovascular repair of thoracic aortic lesions involving the distal aortic arch

Jiechang Zhu et al.

Summary: The study evaluated the outcomes of fenestrated thoracic endovascular aortic repair using single physician-modified stent grafts, showing a technical success rate of 94.8%. The 30-day mortality and perioperative ischemic stroke rate were both 1.7%. All target vessels remained patent during a mean follow-up of 26.3 months, with an all-cause mortality of 5.2%.

INTERACTIVE CARDIOVASCULAR AND THORACIC SURGERY (2021)

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Article Surgery

Effect of the urgency and landing zone on rates of in-hospital death, stroke, and paraplegia after thoracic endovascular aortic repair in Japan

Katsuyuki Hoshina et al.

Summary: This study utilized data from a national registry in Japan to investigate the outcomes of TEVAR for thoracic aortic aneurysm and aortic dissection. The analysis revealed a strong association between urgency and mortality, stroke, and paraplegia, and highlighted the importance of the length and position of stent graft coverage in predicting adverse outcomes.

JOURNAL OF VASCULAR SURGERY (2021)

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Article Peripheral Vascular Disease

Stroke rate after thoracic endovascular aortic repair using de-airing of stentgrafts with high-volume of saline solution

Daniela Branzan et al.

Summary: The study aimed to determine the rate of ischemic stroke following TEVAR with de-airing of thoracic stentgrafts with high-volume of 0.9% heparinized saline solution. Results showed that this method is safe and effective in reducing in-hospital rates of ischemic stroke and spinal cord ischemia, with no further in-hospital events observed.

VASA-EUROPEAN JOURNAL OF VASCULAR MEDICINE (2021)

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Article Cardiac & Cardiovascular Systems

Results of endovascular aortic arch repair using the Relay Branch system

Martin Czerny et al.

Summary: 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.

EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY (2021)

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Article Surgery

Four-year results of the Bolton relay proximal scallop endograft in the management of thoracic and thoracoabdominal aortic pathology with unfavorable proximal landing zone

Lydia Hanna et al.

Summary: Scallop-TEVAR is a useful treatment strategy to extend the proximal landing zone and maintain perfusion to the supra-aortic trunks, providing a durable repair with low reintervention rate, although periprocedural stroke remains a principal concern.

JOURNAL OF VASCULAR SURGERY (2021)

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Article Surgery

Multicenter global early feasibility study to evaluate total endovascular arch repair using three-vessel inner branch stent-grafts for aneurysms and dissections

Emanuel R. Tenorio et al.

Summary: The evaluation of outcomes of total endovascular aortic arch repair using three-vessel inner branch stent-grafts for aneurysms and chronic dissections showed high technical feasibility and safety. Mortality and stroke rates were favorable compared to open surgical repair, but a high rate of secondary interventions highlights the need for more experience and longer follow-up.

JOURNAL OF VASCULAR SURGERY (2021)

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Article Surgery

Double fenestrated physician-modified stent-grafts for total aortic arch repair in 50 patients

Lucien Chassin-Trubert et al.

Summary: This study evaluated the early and medium-term outcomes of using double fenestrated physician-modified endovascular grafts (PMEGs) for total endovascular aortic arch repair. The technical success rate was high, with low 30-day mortality and no conversions to open surgical repair required. These results suggest that double fenestrated PMEGs are feasible and effective for total endovascular aortic arch repair, with a lower stroke risk compared to alternative strategies.

JOURNAL OF VASCULAR SURGERY (2021)

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Article Cardiac & Cardiovascular Systems

Management of arch aneurysms with a single-branch thoracic endograft in zone 0

Michael D. Dake et al.

Summary: Preliminary data from a patient cohort undergoing thoracic endovascular aortic repair for Ishimaru zone 0 and 1 using a novel branched arch endograft showed successful outcomes in achieving device delivery and branch vessel patency without 30-day mortality or stroke. The study demonstrated the feasibility of endovascular repair of arch aortic aneurysms using the new branched arch endograft, with no type I or III endoleaks reported and all side branches patent at 12-month follow-up. Future research will focus on evaluating mid-term outcomes and postoperative neurologic events.

JTCVS TECHNIQUES (2021)

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Article Surgery

A Novel Shaggy Aorta Scoring System to Predict Embolic Complications Following Thoracic Endovascular Aneurysm Repair

Koji Maeda et al.

EUROPEAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY (2020)

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Editorial Material Surgery

Stroke From Thoracic Endovascular Procedures (STEP) Collaboration

Fiona Rohlffs et al.

EUROPEAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY (2020)

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Article Surgery

Association of upper extremity and neck access with stroke in endovascular aortic repair

Anastasia Plotkin et al.

JOURNAL OF VASCULAR SURGERY (2020)

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Article Surgery

Stroke rate after endovascular aortic interventions in the Society for Vascular Surgery Vascular Quality Initiative

Nicholas J. Swerdlow et al.

JOURNAL OF VASCULAR SURGERY (2020)

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Article Surgery

Endovascular Repair of Aortic Dissection Involving the Left Subclavian Artery by Castor Stent Graft: A Multicentre Prospective Trial

Zaiping Jing et al.

EUROPEAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY (2020)

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Article Radiology, Nuclear Medicine & Medical Imaging

Endovascular Outcomes in Aortic Arch Repair with Double and Triple Parallel Stent Grafts

Baolei Guo et al.

JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY (2020)

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Article Peripheral Vascular Disease

Long-Term Clinical Outcomes of Thoracic Endovascular Aortic Repair for Arch Aneurysms with the Najuta Thoracic Stent-Graft System

Hiroshi Sato et al.

ANNALS OF VASCULAR DISEASES (2020)

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Article Cardiac & Cardiovascular Systems

How to minimize air embolisms during thoracic endovascular aortic repair with Relay Pro?

Bartosz Rylski et al.

INTERACTIVE CARDIOVASCULAR AND THORACIC SURGERY (2020)

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Article Surgery

iTalian RegIstry of doUble inner branch stent graft for arch PatHology (the TRIUmPH Registry)

Ciro Ferrer et al.

JOURNAL OF VASCULAR SURGERY (2019)

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Article Cardiac & Cardiovascular Systems

Effectiveness of embolic protection filter devices in stroke prevention during endovascular aortic arch repair in significant aortic atheroma patients

Kazuo Shimamura et al.

INTERACTIVE CARDIOVASCULAR AND THORACIC SURGERY (2019)

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Article Surgery

Multicenter Analysis of Endovascular Aortic Arch In Situ Stent-Graft Fenestrations for Aortic Arch Pathologies

Reinhard Kopp et al.

ANNALS OF VASCULAR SURGERY (2019)

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Article Surgery

Distribution of Air Embolization During TEVAR Depends on Landing Zone: Insights From a Pulsatile Flow Model

Vladimir Makaloski et al.

JOURNAL OF ENDOVASCULAR THERAPY (2019)

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Article Surgery

Incidence and Predictors of Neurological Complications Following Thoracic Endovascular Aneurysm Repair in the Global Registry for Endovascular Aortic Treatment

Michele Piazza et al.

EUROPEAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY (2019)

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Article Surgery

Editor's Choice - Current Options and Recommendations for the Treatment of Thoracic Aortic Pathologies Involving the Aortic Arch: An Expert Consensus Document of the European Association for Cardio-Thoracic Surgery (EACTS) & the European Society for Vascular Surgery (ESVS)

Martin Czerny et al.

EUROPEAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY (2019)

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Article Surgery

Air Embolism During TEVAR: Liquid Perfluorocarbon Absorbs Carbon Dioxide in a Combined Flushing Technique and Decreases the Amount of Gas Released From Thoracic Stent-Grafts During Deployment in an Experimental Setting

Fiona Rohlffs et al.

JOURNAL OF ENDOVASCULAR THERAPY (2019)

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Article Surgery

Single-center experience with an inner branched arch endograft

Nikolaos Tsilimparis et al.

JOURNAL OF VASCULAR SURGERY (2019)

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Article Surgery

Cerebral embolization, silent cerebral infarction and neurocognitive decline after thoracic endovascular aortic repair

A. H. Perera et al.

BRITISH JOURNAL OF SURGERY (2018)

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Article Surgery

Air Embolism During TEVAR: An Additional Flush Port on the Delivery System Pusher Significantly Reduces the Amount of Air Released During Deployment of a Thoracic Stent-Graft in an Experimental Setting

Fiona Rohlffs et al.

JOURNAL OF ENDOVASCULAR THERAPY (2018)

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Article Surgery

Cerebral embolic protection in thoracic endovascular aortic repair

Gagandeep Grover et al.

JOURNAL OF VASCULAR SURGERY (2018)

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Article Cardiac & Cardiovascular Systems

Cerebral embolic protection during endovascular arch replacement

Christine R. Herman et al.

ANNALS OF CARDIOTHORACIC SURGERY (2018)

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Article Surgery

Air Embolism During TEVAR: Carbon Dioxide Flushing Decreases the Amount of Gas Released From Thoracic Stent-Grafts During Deployment

Fiona Rohlffs et al.

JOURNAL OF ENDOVASCULAR THERAPY (2017)

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Article Surgery

Thoracic Endovascular Aortic Repair With Single/Double Chimney Technique for Aortic Arch Pathologies

Tun Wang et al.

JOURNAL OF ENDOVASCULAR THERAPY (2017)

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Article Surgery

Thoracic endovascular aortic repair with branched Inoue Stent Graft for arch aortic aneurysms

Junichi Tazaki et al.

JOURNAL OF VASCULAR SURGERY (2017)

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Article Cardiac & Cardiovascular Systems

Open Surgical Repair Remains the Gold Standard for Treating Aortic Arch Pathology

Vishal Khullar et al.

ANNALS OF THORACIC SURGERY (2017)

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Editorial Material Surgery

Editor's Choice - Subsequent Results for Arch Aneurysm Repair with Inner Branched Endografts

R. Spear et al.

EUROPEAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY (2016)

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Article Surgery

Carbon Dioxide Flushing Technique to Prevent Cerebral Arterial Air Embolism and Stroke During TEVAR

Tilo Koelbel et al.

JOURNAL OF ENDOVASCULAR THERAPY (2016)

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Article Medicine, General & Internal

Multivariate Analysis of Risk Factors of Cerebral Infarction in 439 Patients Undergoing Thoracic Endovascular Aneurysm Repair

Yuji Kanaoka et al.

MEDICINE (2016)

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Article Medicine, General & Internal

Air bubbles are released by thoracic endograft deployment: An in vitro experimental study

Kamuran Inci et al.

SAGE OPEN MEDICINE (2016)

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Article Surgery

Results of the Valiant Mona LSA early feasibility study for descending thoracic aneurysms

Eric E. Roselli et al.

JOURNAL OF VASCULAR SURGERY (2015)

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Article Cardiac & Cardiovascular Systems

Global experience with an inner branched arch endograft

Stephan Haulon et al.

JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY (2014)

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Article Surgery

Impact on outcomes by measuring tortuosity with reporting standards for thoracic endovascular aortic repair

Chun-Ku Chen et al.

JOURNAL OF VASCULAR SURGERY (2014)

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Article Cardiac & Cardiovascular Systems

The next generation of fenestrated endografts: results of a clinical trial to support an expanded indication for aortic arch aneurysm treatment

Takashi Azuma et al.

EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY (2013)

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Article Surgery

Analysis of Stroke after TEVAR Involving the Aortic Arch

G. Melissano et al.

EUROPEAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY (2012)

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Article Surgery

Vascular distribution of stroke and its relationship to perioperative mortality and neurologic outcome after thoracic endovascular aortic repair

Brant W. Ullery et al.

JOURNAL OF VASCULAR SURGERY (2012)

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Article Surgery

Morphological risk factors of stroke during thoracic endovascular aortic repair

Drosos Kotelis et al.

LANGENBECKS ARCHIVES OF SURGERY (2012)

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Article Surgery

Transcranial Doppler findings during thoracic endovascular aortic repair

Jean Bismuth et al.

JOURNAL OF VASCULAR SURGERY (2011)

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Article Cardiac & Cardiovascular Systems

Extent of Thoracic Aortic Atheroma Burden and Long-Term Mortality After Cardiothoracic Surgery A Computed Tomography Study

Vikram Kurra et al.

JACC-CARDIOVASCULAR IMAGING (2010)

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Article Cardiac & Cardiovascular Systems

Predictive Factors for Cerebrovascular Accidents After Thoracic Endovascular Aortic Repair

Giovanni Mariscalco et al.

ANNALS OF THORACIC SURGERY (2009)

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Article Surgery

Neurologic complications associated with endovascular repair of thoracic aortic pathology: Incidence and risk factors. A study from the European Collaborators on Stent/Graft Techniques for Aortic Aneurysm Repair (EUROSTAR) Registry

Jacob Buth et al.

JOURNAL OF VASCULAR SURGERY (2007)

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Article Cardiac & Cardiovascular Systems

Risk factors for perioperative stroke after thoracic endovascular aortic repair

Jacob T. Gutsche et al.

ANNALS OF THORACIC SURGERY (2007)

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Article Cardiac & Cardiovascular Systems

Risk factors of neurologic deficit after thoracic aortic endografting

Ali Khoynezhad et al.

ANNALS OF THORACIC SURGERY (2007)

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Avoiding Stroke in Patients Undergoing Endovascular Aortic Arch Repair JACC Review Topic of the Week

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