A1 Refereed original research article in a scientific journal
Evaluation of custom-made Relay® stent-grafts for aortic arch landing zones 0 and I : experience from two high-volume aortic centres
Authors: Dabravolskaite, Vaiva; Makaloski, Vladimir; Hakovirta, Harri; Kotelis, Drosos; Schoenhoff, Florian S.; Lescan, Mario
Publisher: Oxford University Press
Publishing place: CARY
Publication year: 2024
Journal: European Journal of Cardio-Thoracic Surgery
Journal name in source: EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY
Journal acronym: EUR J CARDIO-THORAC
Article number: ezae241
Volume: 66
Issue: 1
Number of pages: 10
ISSN: 1010-7940
eISSN: 1873-734X
DOI: https://doi.org/10.1093/ejcts/ezae241
Web address : https://academic.oup.com/ejcts/article-abstract/66/1/ezae241/7712429
OBJECTIVES To report experience with a Relay (R) stent-graft custom-made platform in treating different aortic arch pathology in 2 high-volume aortic centres. METHODS A retrospective analysis of all patients treated between July 2016 and July 2023 with custom-made Relay (R) stent-graft (custom-made device). Underlying aortic arch pathology was an aneurysm, penetrating aortic ulcer, and dissection. Three custom-made device designs were used: proximal scallop, fenestrations, and inner branches. The endpoints were technical success, perioperative stroke, death, and reintervention rate. RESULTS Thirty-five patients (89% males) with a mean age of 70 +/- 11 years were treated. Indication for treatment was penetrating aortic ulcer in 14 patients (40%), aneurysm in 11 patients (31%) and aortic dissection in 10 patients (29%). The technical success rate was 100%. Twenty-eight patients (80%) had proximal sealing in zone 0, and 7 (20%) had proximal sealing in zone 1. Nine patients (25.6%) had proximal scallops, 9 (25.6%) had 1 big fenestration and 17 (48.8%) had a branched device; 1 with single branch, 15 with double branches and 1 with triple branches. Thirty patients (86%) had previous or simultaneous left subclavian artery revascularization. No patient died during 30 days. Two patients (5.7%) had stroke postoperatively; both recovered without disabling deficits. The mean follow-up was 35 +/- 26 months. Six patients (17.1%) died during follow-up. One patient required reinforcement of the bridging stent in the left common carotid artery and one additional vascular plugging of the left subclavian artery. Three patients received distal extension. RESULTS Thirty-five patients (89% males) with a mean age of 70 +/- 11 years were treated. Indication for treatment was penetrating aortic ulcer in 14 patients (40%), aneurysm in 11 patients (31%) and aortic dissection in 10 patients (29%). The technical success rate was 100%. Twenty-eight patients (80%) had proximal sealing in zone 0, and 7 (20%) had proximal sealing in zone 1. Nine patients (25.6%) had proximal scallops, 9 (25.6%) had 1 big fenestration and 17 (48.8%) had a branched device; 1 with single branch, 15 with double branches and 1 with triple branches. Thirty patients (86%) had previous or simultaneous left subclavian artery revascularization. No patient died during 30 days. Two patients (5.7%) had stroke postoperatively; both recovered without disabling deficits. The mean follow-up was 35 +/- 26 months. Six patients (17.1%) died during follow-up. One patient required reinforcement of the bridging stent in the left common carotid artery and one additional vascular plugging of the left subclavian artery. Three patients received distal extension. CONCLUSIONS The Relay (R) stent-graft custom-made platform showed a good performance in our study with a high technical success rate, low perioperative stroke and mortality, and low reintervention rates during the follow-up.
