Department of Cardiovascular Surgery, University Heart Center Freiburg-Bad Krozingen, Bad Krozingen, Germany.
Department of Radiology, CHU Rangueil, Toulouse, France.
Eur J Cardiothorac Surg. 2021 Sep 11;60(3):662-668. doi: 10.1093/ejcts/ezab160.
Our goal was to evaluate results of endovascular aortic arch repair using the Relay Branch system.
Forty-three patients with thoracic aortic pathology involving the aortic arch have been treated with the Relay Branch system (Terumo Aortic, Sunrise, FL, USA) in 10 centres. We assessed in-hospital mortality, neurological injury, treatment success according to current reporting standards and the need for secondary interventions. In addition, outcome was analysed according to the underlying pathology: non-dissective disease versus residual aortic dissection (RAD) (defined as remaining dissection after previous type A repair, chronic type B aortic dissections).
In-hospital mortality was 9% (0% in patients with RAD). Disabling stroke occurred in 7% (0% in patients with RAD); non-disabling stroke occurred in 19% (7% in patients with RAD). Early type IA and B endoleak formation occurred in 4%. Median follow-up was 16 ± 18 months. During the follow-up period, 23% of the patients died. Aortic-related deaths were low (3% in patients with RAD).
The results of endovascular aortic arch repair using the Relay Branch system in a selected patient population with regard to technical success are good. In-hospital mortality is acceptable, the number of disabling strokes is low and technical success is high. Non-disabling stroke is a major concern, and every effort has to be taken to reduce this to a minimum. The best outcome is seen in patients with underlying RAD. Finally, more data are needed.
我们的目标是评估使用 Relay Branch 系统进行主动脉弓血管内修复的结果。
在 10 个中心，使用 Relay Branch 系统（Terumo Aortic，Sunrise，FL，美国）治疗了 43 例涉及主动脉弓的胸主动脉病变患者。我们评估了院内死亡率、神经损伤、根据当前报告标准的治疗成功率以及对二次干预的需求。此外，根据潜在的病理学对结果进行了分析：非夹层疾病与残余主动脉夹层（RAD）（定义为先前 A 型修复后仍存在夹层，慢性 B 型主动脉夹层）。
院内死亡率为 9%（RAD 患者为 0%）。发生致残性卒中 7%（RAD 患者为 0%）；发生非致残性卒中 19%（RAD 患者为 7%）。早期 I 型和 B 型内漏形成占 4%。中位随访时间为 16±18 个月。在随访期间，23%的患者死亡。与主动脉相关的死亡率较低（RAD 患者为 3%）。
在选择的患者人群中，使用 Relay Branch 系统进行主动脉弓血管内修复的结果在技术成功方面是良好的。院内死亡率可接受，致残性卒中的数量较低，技术成功率较高。非致残性卒中是一个主要关注点，必须尽一切努力将其降至最低。RAD 患者的预后最佳。最后，需要更多的数据。
