Li Xin, Shu Chang, Wang Lunchang, Li Quanming, Fang Kun, Luo Mingyao, Zhang Weichang, Zhou Yang, Zhou Haiyang
Department of Vascular Surgery, The Second Xiangya Hospital of Central South University, Changsha, China.
Institute of Vascular Diseases, Central South University, Changsha, China.
Front Cardiovasc Med. 2022 Jun 30;9:911689. doi: 10.3389/fcvm.2022.911689. eCollection 2022.
To report the technology and preliminary result of gutter-free design stent-grafted in fenestration thoracic endovascular aortic repair (TEVAR).
The gutter-free stent-graft has a nickel-titanium self-expanding skeleton, double polytetrafluoroethylene coating, and an outer-skirt fabric structure (named C-skirt endograft). The outer skirt fabric prevents endoleak from the gutter around the stent graft fenestration. Further, the skirt structure right under the fenestration in the aortic stent graft can function as a fixation of the side-branch artery endograft. These designs have the following advantages, such as: 1) prevention of endoleak; and 2) fixation tightly between the branch and aorta endograft pieces.
A patient who was diagnosed with an aortic arch aneurysm, combined with localized dissection, has successfully implanted the aortic stent graft and C-skirt endograft for the left subclavian artery. The 6-month follow-up result of the C-skirt in situ fenestration TEVAR is satisfactory without obvious endoleak.
The new gutter-free C-skirt stent graft is being safely and effectively used for aortic arch TEVAR. Long-term evaluation of safety, effectivity, and durability needs to be proven by future multi-center studies.
报告无间隙设计的支架型人工血管在开窗胸主动脉腔内修复术（TEVAR）中的技术及初步结果。
无间隙支架型人工血管具有镍钛自膨式骨架、双层聚四氟乙烯涂层及外裙边织物结构（称为C裙边腔内移植物）。外裙边织物可防止支架型人工血管开窗周围间隙发生内漏。此外，主动脉支架型人工血管开窗正下方的裙边结构可起到固定分支动脉腔内移植物的作用。这些设计具有以下优点，如：1）预防内漏；2）分支与主动脉腔内移植物部件之间紧密固定。
一名被诊断为主动脉弓瘤合并局限性夹层的患者成功植入了主动脉支架型人工血管及用于左锁骨下动脉的C裙边腔内移植物。C裙边原位开窗TEVAR的6个月随访结果令人满意，无明显内漏。
新型无间隙C裙边支架型人工血管正安全有效地用于主动脉弓TEVAR。其安全性、有效性及耐久性的长期评估有待未来多中心研究证实。
