Results From a Nationwide Registry on Scalloped Thoracic Stent-Grafts for Short Landing Zones. (February 2017)

• Record Type: Journal Article
• Authors: van der Weijde, Emma; Bakker, Olaf J.; Tielliu, Ignace F. J.; Zeebregts, Clark J.; Heijmen, Robin H.
• Is Part Of: Journal of endovascular therapy. Volume 24:Number 1(2017:Feb.)
• Page Start: 97
• Page End: 106
• Publication Date: 2017-02
• Subjects: aneurysm -- aortic arch -- endoleak -- landing zone -- pseudoaneurysm -- scallop -- stent-graft -- thoracic aortic pathology -- thoracic endovascular aortic repair -- type B dissection; Blood-vessels -- Endoscopic surgery -- Periodicals; Angioscopy -- Periodicals; Intravenous catheterization -- Periodicals; Peripheral vascular diseases -- Treatment -- Periodicals; Vascular Surgical Procedures -- Periodicals; Angioscopy -- Periodicals; Catheterization, Peripheral -- Periodicals; Peripheral Vascular Diseases -- therapy -- Periodicals; Angioscopie; Maladies vasculaires périphériques; 617.413
• DOI: 10.1177/1526602816674942
• Languages: English
• ISSNs: 1526-6028

Abstract

Purpose: To report the perioperative results and short-term follow-up of patients treated with scalloped thoracic stent-grafts.Methods: A multicenter registry in the Netherlands captured data on 30 patients (mean age 68 years; 17 men) with thoracic aortic pathology and a short (<20 mm) proximal or distal landing zone who received a custom-made scalloped stent-graft between January 2013 and February 2016. Patients were treated for saccular (n=13) aneurysms, fusiform (n=9) aneurysms, pseudoaneurysms (n=4), or chronic type B dissections (n=4). The scallop was used to preserve flow in the left subclavian artery (LSA) (n=17), left common carotid artery (n=5), innominate artery (n=1), and celiac trunk (n=7). In 7 (23%) patients, the scallop also included the adjacent artery.Results: Technical success was achieved in 28 (93%) patients. In 1 patient, a minor type Ia endoleak was observed intraoperatively, which was no longer visible on computed tomography angiography at 3 months. In another patient, the LSA was unintentionally obstructed due to migration of the stent-graft on deployment. Concomitant carotid-carotid or carotid-subclavian bypass was performed in 4 patients. There was no retrograde type A dissection or conversion to open surgery. In-hospital mortality was 3%, and the perioperative ischemic stroke rate was 3%. At a mean follow-up of 9.7 months (range <1 to 31), 29 of 30 target vessels were patent.Conclusion: The scalloped stent-graft appears to be a safe and relatively simple alternative for the treatment of thoracic aortic lesions with short landing zones. Larger patient series and long-term follow-up are required to confirm these early results.