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RELAY研究:血管通畅性和再次干预的国际分支研究结果

RELAY Branched-International Results of Vessel Patency and Reintervention.

作者信息

Singh Sidhant, Surkhi Abedalaziz O, Tan Sven Z C P, Jubouri Matti, Bailey Damian M, Williams Ian, Bashir Mohamad

机构信息

Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom.

Faculty of Medicine, Al-Quds University, Jerusalem, Palestine.

出版信息

Front Cardiovasc Med. 2022 Jun 29;9:962884. doi: 10.3389/fcvm.2022.962884. eCollection 2022.

Abstract

BACKGROUND

Surgical intervention remains the mainstay treatment for aortic arch aneurysm and dissection, but the high mortality and morbidity rates have led to a need for the development of minimally invasive alternatives to arch reconstruction. RELAY™ Branched (Terumo Aortic, Inchinnan, UK) represents a viable option for complex endovascular aortic arch repair. We present multi-center data from Europe documenting the efficacy of the endograft in terms of its target vessel patency and reintervention rates.

METHODS

Prospective data collected between January 2019 and January 2022 associated with patients treated with RELAY™ single-, double-, and triple-branched endoprostheses from centers across Europe was retrospectively analyzed with descriptive and distributive analysis. Follow up data from 30 days and 6-, 12-, and 24 months postoperatively was included. Patient follow up was evaluated in terms of target vessel patency and reintervention rates.

RESULTS

Technical success was achieved in 147 (99.3%) cases. Over 24 months period, target vessel patency was maintained in 80.2% ( = 118) of patients. Target vessel cannulation was achieved in 146 (99.3%) cases. Over the 24-month follow-up period, 30 reintervention procedures were required, of which 29 (97%) took place within the South Europe region which accounted for 19.6% ( = 29) of total cases. Zero reinterventions were required in patients that were treated with single- or triple-branched endoprostheses.

DISCUSSION

The data presented herein demonstrates that RELAY™ Branched is a technically efficacious device for endovascular aortic arch repair and is associated with favorable target vessel patency and reintervention rates. Key design features of the endoprosthesis and good perioperative management can contribute greatly to mitigating reintervention and loss of vessel patency following endovascular aortic arch repair.

摘要

背景

手术干预仍是主动脉弓动脉瘤和夹层的主要治疗方法,但高死亡率和发病率促使人们需要开发微创的主动脉弓重建替代方案。RELAY™分支型(泰尔茂主动脉公司,英国因奇南)是复杂的血管内主动脉弓修复的一个可行选择。我们展示了来自欧洲的多中心数据,记录了该腔内移植物在靶血管通畅率和再次干预率方面的疗效。

方法

对2019年1月至2022年1月期间欧洲各中心使用RELAY™单分支、双分支和三分支腔内移植物治疗的患者的前瞻性数据进行回顾性分析,采用描述性和分布性分析。纳入术后30天以及6、12和24个月的随访数据。根据靶血管通畅率和再次干预率对患者随访情况进行评估。

结果

147例(99.3%)手术获得技术成功。在24个月期间,80.2%(n = 118)的患者靶血管保持通畅。146例(99.3%)实现了靶血管插管。在24个月的随访期内,共需要进行30次再次干预手术,其中29次(97%)发生在南欧地区,该地区占总病例数的19.6%(n = 29)。接受单分支或三分支腔内移植物治疗的患者无需再次干预。

讨论

本文展示的数据表明,RELAY™分支型是一种用于血管内主动脉弓修复的技术有效的装置,且靶血管通畅率良好,再次干预率较低。腔内移植物的关键设计特点和良好的围手术期管理可极大地有助于减少血管内主动脉弓修复术后的再次干预和血管通畅性丧失。

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J Card Surg. 2022 Apr;37(4):987-992. doi: 10.1111/jocs.16267. Epub 2022 Jan 27.
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Zone 0 Aortic Arch Reconstruction Using the RelayBranch Thoracic Stent Graft.
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