Hussain Mariam, Jubouri Yousif F, Hammad Aya, Abubacker Ihsan, Franchin Marco, Mauri Francesca, Piffaretti Gabriele, Mohammed Idhrees, Jubouri Matti, Bashir Mohamad
Hull York Medical School, University of York, York, UK.
Aston Medical School, Aston University, Birmingham, UK.
Expert Rev Med Devices. 2025 Mar;22(3):193-208. doi: 10.1080/17434440.2025.2471455. Epub 2025 Mar 24.
Thoracic aortic pathologies implicating the aortic arch and the descending thoracic aorta (DTA) are primarily managed with total aortic arch replacement (TAR). This can be performed as a single-procedure hybrid fashion using the frozen elephant trunk technique (FET), which utilizes hybrid prosthesis. Nevertheless, FET presents certain challenges such as distal stent graft-induced new entry (dSINE), negative aortic remodeling, and reintervention.
The narrative review provides an overview of the four majors FET prosthesis, highlighting their design features, mechanical properties, configurations, and variants, and evaluating their clinical outcomes reported in the literature. The leading prosthesises were compared through their mortality and survival rates, neurological outcomes, dSINE, aortic remodeling, and reintervention rates.
Four FET devices can be considered the main option on the global market; Thoraflex, E-Vita, Cronus, and Frozenix J Graft. Each hybrid prosthesis (HP) features unique design characteristics, resulting in varying clinical outcomes. Thoraflex and E-Vita are the most widely used and investigated HPs, whilst the use of Cronus and Frozenix is geographically confined to mainly manufacturers' countries. The rates of early mortality, stroke, SCI, dSINE, and reintervention rates were found to be comparable among the four devices, yet, Thoraflex seemed to offer the most optimal clinical profile.
累及主动脉弓和降主动脉（DTA）的胸主动脉病变主要通过全主动脉弓置换术（TAR）进行治疗。这可以采用单一手术的混合方式，即使用冷冻象鼻技术（FET），该技术采用混合假体。然而，FET存在一些挑战，如远端支架移植物引起的新破口（dSINE）、主动脉负性重塑和再次干预。
本叙述性综述概述了四种主要的FET假体，强调了它们的设计特点、机械性能、构型和变体，并评估了文献中报道的它们的临床结果。通过死亡率和生存率、神经学结果、dSINE、主动脉重塑和再次干预率对领先的假体进行了比较。
四种FET装置可被视为全球市场上的主要选择；Thoraflex、E-Vita、Cronus和Frozenix J Graft。每种混合假体（HP）都具有独特的设计特点，导致不同的临床结果。Thoraflex和E-Vita是使用最广泛且研究最多的HPs，而Cronus和Frozenix的使用在地理上主要局限于制造商所在国家。发现这四种装置的早期死亡率、中风、脊髓损伤、dSINE和再次干预率相当，然而，Thoraflex似乎提供了最理想的临床概况。
