Preliminary Experiences With a Novel Unibody Endograft System for Total Percutaneous Endovascular Repair for Complex Aortic Arch Dissection.

Abstract

Endovascular repair has emerged as a less invasive alternative treatment for residual arch disease after limited repair of type A aortic dissection. However, cervical or supraclavicular incisions are generally required to establish access for branch bridging stent-graft deployment. This study aimed to assess the feasibility of total percutaneous endovascular arch repair using an innovative off-the-shelf unibody endograft system. Patients who underwent endovascular aortic arch repair with a unibody endograft system for residual arch dissection from September 2023 to January 2024 were included. The primary outcome was the incidence of major adverse events within 30 days postoperatively. A total of 4 men with a median age of 56.5 years (interquartile range [IQR], 48-60.5 years) were included. Procedural technical success was achieved in all patients. The median surgery duration was 128 minutes (IQR, 117-167.5 minutes), with an endovascular procedure time (from the first aortic stent-graft delivery system insertion to the last bridging stent-graft delivery system retrieval) of 75 minutes (IQR, 55.5-80.5 minutes). After a median follow-up of 1 year (IQR, 366-456 days), no deaths, stroke, paraplegia, stent-graft stenosis, fractures, migrations, or access complications were observed. One patient received a diagnosis of endoleak from branch reentries and underwent endovascular reintervention 1 month postoperatively. Preliminary results of this study have demonstrated the technical feasibility of endovascular repair using the novel unibody endograft system for residual arch dissection through a total percutaneous approach. Further research is warranted to confirm its long-term efficacy and safety.