Department of Cardiovascular Surgery, West China Hospital, Sichuan University, No. 37 Guo Xue Alley, Chengdu, 610041, Sichuan, China.
National Center for Cardiovascular Diseases, Fuwai Hospital, CAMS & PUMC, Beijing, China.
Cardiovasc Intervent Radiol. 2023 Jun;46(6):703-712. doi: 10.1007/s00270-023-03444-8. Epub 2023 May 17.
To report the early 2-year results and experience of a novel gutter-plugging chimney stent-graft in a single center that participated in the clinical trial of Prospective Study for Aortic Arch Therapy with stENt-graft for Chimney technology.
Patients diagnosed with aortic dissection were treated with the novel chimney stent-grafts named Longuette™ for the left subclavian artery revascularization. Primary study outcomes were the incidence of freedom from major adverse events within 30 days and success rate of the operation over 12 months.
A total of 34 patients were enrolled between September 2019 and December 2020. The immediate technical success rate (stent-grafts successfully deployed without fast-flow type Ia or type III endoleak intraoperatively) was 100%, and there were no conversions to open repair. Type Ia and type II endoleaks were noted in three patients (8.8%) and one patient (2.9%) at discharge, respectively. One patient (2.9%) with type Ia endoleak underwent coil embolization at 12 months because of false lumen dilation, and one (2.9%) case of type Ia endoleak resolved spontaneously at 24 months. One chimney stent (2.9%) was revealed with stenosis at discharge and occluded with thrombosis at 6 months postoperatively. During the 2-year follow-up, there was no death, rupture, stroke, paraplegia, left arm ischemia, retrograde dissection, stent-graft induced new entry, or stent migration.
The initial results of the Longuette™ stent-graft for revascularization of the left subclavian artery are encouraging with a high technical success rate. Further multicenter follow-up outcomes are required to assess the long-term durability.
Level 4, Case Series.
报告参与 Prospective Study for Aortic Arch Therapy with stENt-graft for Chimney technology 临床试验的单中心使用新型烟囱支补片支架治疗的 2 年早期结果和经验。
诊断为主动脉夹层的患者使用新型烟囱支补片支架（名为 Longuette™）进行左锁骨下动脉血运重建。主要研究结果为 30 天内无重大不良事件发生率和 12 个月内手术成功率。
2019 年 9 月至 2020 年 12 月期间共纳入 34 例患者。即时技术成功率（支架成功植入，术中无快速血流型 Ia 或 III 型内漏）为 100%，无转为开放修复。出院时分别有 3 例（8.8%）和 1 例（2.9%）患者出现 Ia 型和 II 型内漏。1 例（2.9%）Ia 型内漏患者因假腔扩张在 12 个月时行弹簧圈栓塞，1 例（2.9%）Ia 型内漏在 24 个月时自发缓解。1 个烟囱支架（2.9%）在出院时显示狭窄，术后 6 个月闭塞伴血栓形成。2 年随访期间，无死亡、破裂、中风、截瘫、左臂缺血、逆行夹层、支架诱导新入口或支架移位。
Longuette™ 支架用于左锁骨下动脉血运重建的初始结果令人鼓舞，技术成功率高。需要进一步的多中心随访结果来评估长期耐久性。
4 级，病例系列。
