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Repair of descending thoracic aortic aneurysms with Ankura Thoracic Stent Graft

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Objective The aim of the study was to present the results for patients with atherosclerotic aneurysm of the descending thoracic aorta (DTA) treated with a novel thoracic stent graft. Methods… Click to show full abstract

Objective The aim of the study was to present the results for patients with atherosclerotic aneurysm of the descending thoracic aorta (DTA) treated with a novel thoracic stent graft. Methods A single‐center retrospective review of prospectively collected data was performed. We extracted demographic variables as well as atherosclerotic comorbidities and operation‐related and imaging‐related data from patients’ medical records. We estimated technical success rate, in‐hospital and 30‐day mortality, and mortality at the end of follow‐up as well as complication and reintervention rate in our study cohort. Follow‐up computed tomography angiography was performed after 1 month and 6 months and yearly thereafter. Results A total of 30 patients (80% male; mean age, 73.7 ± 6.33 years) were treated with Ankura Thoracic Stent Graft (Lifetech, Shenzhen, China) for DTA aneurysm from February 2014 until June 2017. Technical success of the thoracic endovascular aortic repair (TEVAR) was 97% (29/30 patients). A surgical conduit was required in one patient; in three patients, we intentionally covered the left subclavian artery because of insufficient proximal landing zone. No aorta‐related deaths were recorded during follow‐up. During the early postoperative period, two patients (7%) with long DTA coverage developed paralysis or paraparesis, which immediately resolved after lumbar drainage. No renal complications requiring dialysis were observed. One patient (3%) developed postoperative pulmonary infection, whereas access site complications were 7%. Two symptomatic patients treated outside instructions for use (7%) developed early type IA endoleak and one patient (3%) developed type IB endoleak; type II endoleak was recorded in 3% of the study cohort. During the 30‐day postoperative period, two patients died of non‐TEVAR‐related causes, one of gastrointestinal bleeding and the other of pulmonary infection. During a median follow‐up of 31.7 (range, 38.4) months, two more patients also died of non‐TEVAR‐related causes, one of stroke from carotid artery disease and the other of motor vehicle trauma. In the rest of the cohort, no other adverse events were noted. Conclusions This novel endograft showed early evidence of a safe, effective, and durable endoprosthesis for the treatment of DTA aneurysms.

Keywords: thoracic stent; stent graft; ankura thoracic; descending thoracic

Journal Title: Journal of Vascular Surgery
Year Published: 2019

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