Preliminary Clinical Study of Contrast-free Endovascular Aortic Repair(FLARE Technique)
10.3969/j.issn.1000-3614.2025.11.007
- VernacularTitle:无对比剂主动脉腔内修复术临床研究初探
- Author:
Hui HAN
1
;
Junyu WANG
;
Xiangyu LI
;
Limin YUAN
;
Kun FANG
;
Chang SHU
;
Mingyao LUO
Author Information
1. 中国医学科学院 北京协和医学院 国家心血管病中心 阜外医院 血管外科中心 心血管疾病国家重点实验室,北京 100037
- Publication Type:Journal Article
- Keywords:
aortic endovascular repair;
contrast agent;
allergy;
renal insufficiency
- From:
Chinese Circulation Journal
2025;40(11):1096-1102
- CountryChina
- Language:Chinese
-
Abstract:
Objectives:To evaluate the safety and feasibility of endovascular aortic repair without contrast agent under branch artery guidewire marking(FLARE technique).Methods:The clinical data of 7 patients who underwent contrast-free endovascular aortic repair with branch artery guidewire marking in Fuwai Hospital from 2024 to 2025 were retrospectively analyzed.The criteria for patient selection included renal insufficiency,history of contrast agent allergy,high risk of high-pressure angiography due to extensive calcification of the aortic arch,and patients'strong personal wishes,all patients merited with anatomically friendly and anchored area criteria.The patients were evaluated by preoperative computed tomography or color Doppler ultrasound,and the occlusive stent anchor point was located by branch artery guidewire marking combined with bone marking during surgery.The primary endpoints were early stage of postoperative renal function changes(comparison of preoperative and postoperative serum creatinine)and surgical technique success rate,and the secondary endpoints included the incidence of internal leakage,re-intervention rates,and incidence of aneurysm and kidney-related adverse events during follow-up.Results:Among the seven patients who underwent endovascular aortic repair without contrast using a branch artery guidewire,four were male,with an average age of(72.0±5.9)years.Six of these patients had infrarenal abdominal aortic aneurysms,two of them with bilateral renal artery severe stenosis and renal insufficiency underwent renal artery stenting combined with endovascular aortic repair,one patient had isolated chronic renal insufficiency,one had a history of iodine contrast skin allergy,and the remaining two cases wished this surgery option.The seventh patient had a penetrating ulcer in the aortic arch and descending aorta,along with extensive thrombosis and calcification in the ascending aorta,aortic arch and descending aorta.All the patients achieved surgical technique success.No iodine contrast agent was used during the procedure for endovascular aortic repair.In patients with chronic renal insufficiency and renal artery stenosis before surgery,serum creatinine levels were significantly improved after surgery.All patients did not need hemodialysis,there was no allergic reaction,and no graft-related or perioperative complications.The average follow-up was(5.8±3.0)months,all patients recovered well without re-intervention or complications.The creatinine levels did not fluctuate significantly after surgery.Conclusions:Branch artery guidewire marked contrast-free aortic endovascular repair may be a safe and feasible treatment option in selected patients,especially in patients with contraindications to contrast agents.
