Thorac Cardiovasc Surg 2017; 65(S 01): S1-S110
DOI: 10.1055/s-0037-1598826
Oral Presentations
Monday, February 13th, 2017
DGTHG: Aortic Disease: Aortic Arch Surgery
Georg Thieme Verlag KG Stuttgart · New York

Semi-Controlled Aortic Stent Graft Deployment in the Distal Landing Zone: Incidence, Reasons and Consequences

M. Berezowski
1   Department of Cardiovascular Surgery, Heart Center Freiburg University, Freiburg, Germany
,
J. Morlock
1   Department of Cardiovascular Surgery, Heart Center Freiburg University, Freiburg, Germany
,
F. Beyersdorf
1   Department of Cardiovascular Surgery, Heart Center Freiburg University, Freiburg, Germany
,
T. Plonek
2   Department and Clinic of Cardiac Surgery, Wroclaw Medical University, Wroclaw, Poland
,
M. Siepe
1   Department of Cardiovascular Surgery, Heart Center Freiburg University, Freiburg, Germany
,
M. Czerny
1   Department of Cardiovascular Surgery, Heart Center Freiburg University, Freiburg, Germany
,
B. Rylski
1   Department of Cardiovascular Surgery, Heart Center Freiburg University, Freiburg, Germany
› Author Affiliations
Further Information

Publication History

Publication Date:
03 February 2017 (online)

   All articles of this category

Objectives: The aim of this study was to investigate precision of stent graft deployment in distal landing zone (LZ) during thoracic endovascular aortic repair (TEVAR). Currently, TEVAR technology focuses on precise stent graft deployment in the proximal LZ. Data on landing in the distal LZ are missing.

Methods: Of 195 TEVAR patients (2005–2016) with non-dissected aortic pathology 59 (aged 73 (68; 77), 20 women) had distal LZ shorter than 40 mm. In all, the aim was to deploy stent graft just above target vessel (celiac trunk, mesenteric superior or renal artery). Patients were divided into the precise landing (PL, n = 10) and imprecise landing (IPL, n = 49) group considering distance to target vessel after TEVAR, target vessel coverage and need for second stent graft in distal LZ. Distal LZ, stent graft distance to target vessel, apposition, migration and endoleak Ib were assessed on computed tomography angiography. Median follow-up was 23 months (5; 48).

Results: Distal LZ anatomy did not differ between groups. Overall stent graft distance to target vessel was 10.0 mm (6.5 mm; 16.0 mm). Three patients required second stent graft in distal LZ and in 3 target vessel was accidentally covered. PL group had lower primary endoleak Ib occurrence compared with IPL (0 vs. 33%; p = 0.049). Substantial stent graft wedge-apposition had 3 (30%) PL and 19 (39%) IPL patients (p = 0.729).

Conclusion: Precise stent graft implantation in distal LZ with currently available deployment mechanism is rarely achievable. Imprecise landing is associated with higher endoleak Ib incidence.