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Outcomes of chimney and fenestrated endografting using Viabahn VBX and atrium iCAST stents. | LitMetric

Outcomes of chimney and fenestrated endografting using Viabahn VBX and atrium iCAST stents.

J Cardiovasc Surg (Torino)

Section of Vascular Surgery and Endovascular Therapy, The University of Chicago Medicine, Chicago, IL, USA.

Published: April 2021

AI Article Synopsis

  • - The Atrium iCAST stent has traditionally been used for complex endovascular aneurysm repairs (ChEVAR and FEVAR), but due to its rigidity, the more flexible Gore Viabahn (VBX) stent has emerged as an alternative.
  • - A study of 53 patients over an average follow-up of 15.6 months found that both VBX and iCAST stents had similar initial and follow-up patency rates, with 100% and 98.7% respectively, and equal rates of complications like Type 1a endoleaks.
  • - Results showed that while the iCAST stent led to a greater decrease in aneurysm sac size compared to the VBX, both

Article Abstract

Background: The Atrium iCAST balloon expandable stent is the traditional choice of stent for chimney and fenestrated endovascular aneurysm repair (ChEVAR and FEVAR respectively). Due to the iCAST's lack of flexibility, the Gore Viabahn balloon-expandable stent (VBX; W. L. Gore & Associates, Inc., Newark, DE, USA) has arisen as a flexible alternative for parallel or branch graft placement during complex EVAR. Our purpose was to analyze patients' outcomes after undergoing ChEVAR or FEVAR using VBX or iCAST stents with the major outcome of assessing stent graft patency. The secondary outcome was residual aneurysm sac behavior.

Methods: We retrospectively reviewed patients who were treated by ChEVAR or FEVAR with placement of iCAST or VBX stents from July 2012 to August 2018. Patients received follow-up CT scan and/or aortic duplex imaging.

Results: We examined 53 cases (70% ChEVAR and 30% FEVAR) with 15.6 months (0-76.5 months) mean follow-up period. Placement of stents included renal (65 iCAST and 38 VBX), superior mesenteric (12 iCAST and 13 VBX), celiac (4 iCAST and 5 VBX), and iliac arteries (1 iCAST and 5 VBX). A total of 143 stents (57% iCAST and 43% VBX) were successfully deployed with 100% initial patency. Follow-up patency was similar for both stent types (100% VBX vs 98.7% iCAST). VBX and iCAST had the same follow-up Type 1a endoleak occurrence (9%). Average aneurysm sac sizes for iCAST decreased more than VBX (9% iCAST and 4% VBX, P=0.21), however, the iCAST group had longer follow-up.

Conclusions: Our experience demonstrates that the use of VBX stents for ChEVAR and FEVAR is a safe and effective alternative to iCAST stents with excellent mid-term patency without a negative impact on endoleak frequency.

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Source
http://dx.doi.org/10.23736/S0021-9509.20.11479-4DOI Listing

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