LAUSR

OBJECT To summarize the experience and outcomes of total endovascular repair of aortic arch disease using 3D printing to guide the application of modified pre-fenestrated/branched stent grafts. PATIENTS AND METHODS From April 2018 to March 2019, 17 patients with aortic arch disease were treated in our department. There were 5 patients with an aortic arch aneurysm and 12 with an aortic arch dissection. There were 13 males and 4 females, with an average age of 57.82 ± 10.47 years. Preoperatively, a 3D-printed model of the aorta was made according to CT data. Then, under the guidance of the 3D-printed aortic model, modified pre-fenestrated/branched stent grafts were prepared, and the diameter of the stent grafts was reduced intraoperatively by a physician for total endovascular repair. Aortic CTA was performed 3 and 6 months after the surgery. RESULTS All procedures were completed in one stage with no conversions to sternotomy. Among all 17 patients, the operation was successful in 16. One patient was treated with a chimney graft and a stent graft fenestrated in situ because of distortion of the stent. The success rate of the technique was 94.18%. The average operation time was 4.18 ± 1.57 h, and no patients died. No neurological complications, such as cerebral infarction or paraplegia, were observed during the follow-up period. CONCLUSIONS 3D printing can be used to help guide the treatment of aortic arch disease using modified pre-fenestrated/branched stent grafts. This minimally invasive total treatment technique is accurate, allows quick recovery and has a low complication rate. The short-term follow-up data show the safety and reliability of the method; however, further research and development are needed.