Comparison of outcomes between implantation and non-implantation of branch stents in thoracic endovascular aortic repair using self-radiopaque marker guided physician modified fenestration for aortic arch diseases
10.3760/cma.j.cn113855-20240328-00228
- VernacularTitle:支架自显影体外开窗后植入分支支架和不植入分支支架临床效果的对比研究
- Author:
Pengcheng GUO
1
;
Mingyao LUO
;
Kun FANG
;
Lei ZHANG
;
Xin LI
;
Chang SHU
Author Information
1. 中南大学湘雅二医院血管外科，长沙 410011
- Publication Type:Journal Article
- Keywords:
Aortic diseases;
Stents;
Endovascular procedures
- From:
Chinese Journal of General Surgery
2025;40(7):539-545
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the clinical outcomes of thoracic endovascular aortic repair (TEVAR) using self-radiopaque marker guided physician modified fenestration with stent-graft in situ fenestration technology with or without the implantation of branch stents for the treatment of aortic arch diseases.Methods:The clinical data of 653 patients with aortic arch diseases who underwent TEVAR using fenestration from Dec 2015 to Jun 2023 at two vascular surgery centers were retrospectively analyzed.Results:A total of 454 patients received branch stent implantation, while 199 did not. The incidence of non-aortic-related complications within 30 days post-operation was higher in the branch stent implantation group compared to the non-implantation group (8.6% vs. 3.5%, P=0.020). The overall follow-up rate was 93.8%, with median follow-up time of 37 months and 52 months for the branch stent implantation group and non-implantation group, respectively. Kaplan-Meier survival analysis showed no significant statistical difference between the two groups in terms of cumulative all-cause survival ( P=0.223), free from endoleak ( P=0.106), and free from branch artery occlusion ( P=0.130). Conclusions:The implantation of branch stents following in situ fenestration with stent-graft technology in TEVAR did not significantly affect overall survival, endoleak incidence, or branch artery occlusion rates in patients with aortic arch diseases. Therefore, the decision to implant branch stents should be tailored according to the specific pathology and anatomical characteristics of the aortic arch.
