First-in-Human Implantation of Gutter-Free Design Chimney Stent Graft for Aortic Arch Pathology.

Abstract

This report describes first-in-human experiences and early results of gutter-free chimney stent graft implantation for aortic arch pathologies. The gutter-free chimney stent graft consists of an inner stent and an outer skirt fabric to form an integrated structure. The inner and outer layers are nickel-titanium self-expanding skeletal structures with double polytetrafluoroethylene coating. The outer skirt fabric fits the gutter to prevent endoleak, and the proximal inner stent has a larger radial force to ensure the blood flow. All these designs have the advantages to overcome the native defects of current chimney techniques. We reported 2 patients who were diagnosed as having aortic arch pathologies and received the gutter-free chimney stent graft implantation during thoracic endovascular aortic repair. In all patients, aortic arch lesions were covered, and supraaortic branches were patent without complications after thoracic endovascular aortic repair and during the 17 months of follow-up. Novel gutter-free chimney stent graft may be safely and effectively utilized for endovascular repair in aortic arch pathologies. Long-term durability should be confirmed by larger studies and ongoing research.