Mid-term results of in situ fenestration stented with balloon-expandable bare metal stents during thoracic endovascular aortic repair.

Purpose: To assess the safety, feasibility and effectiveness of balloon-expandable bare metal stents (BMS) as bridge stents during thoracic endovascular aortic repair (TEVAR).

Materials And Methods: Retrospective analysis was conducted on 103 consecutive patients who underwent TEVAR procedures from December 2015 to March 2018. Thirty-one patients fulfilled requirements for inclusion and exclusion in the analysis. Thirty-three in situ fenestration (ISF) procedures (single fenestration [n = 29]; dual fenestration [n = 2]) were performed in the 31 patients (67.7% men; median age, 61.5 year) who underwent TEVAR for thoracic lesions (aortic dissection [n = 23], aortic aneurysm [n = 3], aortic ulcer [n = 5]) with 34 stents (33 balloon-expandable BMS, 1 covered stents) implanted in supraaortic arteries. The success rate of overall intervention, fenestration, and implantation of BMS was recorded. The therapeutic effects and complications during admission and follow-up (median 29.7 months, range 18-45 months) were the primary outcomes.

Results: The technical success rate was 90.3% (28/31). All thoracic lesions were totally excluded. Major complications (6.5%) were one dissection in the left subclavian artery (n = 1) and thrombus formation (n = 1). Minor complications (12.9%) were hematoma (n = 1), and type III endoleak (n = 3). During follow-up, no endoleak developed and all fenestrated branch arteries were patent, except for one left subclavian artery dissection and occlusion.

Conclusions: Use of balloon-expandable BMS in ISF is safe and effective in reconstruction of supraarotic arteries during TEVAR.