CONCLUSIONS: Adjunctive false lumen embolization with a covered stent device promotes thrombosis and remodeling after stent-grafting the true lumen for chronic dissection. Further study of this strategy is warranted. AUTHOR DISCLOSURES: J. Idrees: Nothing to disclose; J. Reside: Nothing to disclose; E.E. Roselli: Medtronic, speakers bureau; Cook, speakers bureau; Vascuteck, speakers bureau; Medtronic, honorarium; Cook, honorarium; Vascuteck, honorarium; T. Sarac: Nothing to disclose; S. Shafii: Nothing to disclose.
PS20. Outcomes of Fenestrated and Branched Aortic Arch Endografts for Patients Unfit for Open Surgery
4:25 p.m.
Nikolaos Tsilimparis, E. Sebastian Debus, Sabine Wipper, Sebastian Carpenter, Axel Larena, Tilo Kölbel.
Department of Vascular Medicine, University Heart Center, Hamburg, Germany.
OBJECTIVES: Evaluate the outcomes of high-risk patients receiving elective repair of aortic arch pathologies with customized fenestrated or branched stent grafts (FBSG). METHODS: Single-center, prospective, non-comparative study using customized fenestrated grafts or the Zenith Arch-branch® endograft (Cook Medical). All patients were denied open surgical therapy. RESULTS: During a 2-year period, 14 patients (10 , age 66±8 years) received FBSG involving the aortic arch (6 customized fenestrated, 8 Zenith A-branch). Six patients had previous thoracic aortic repair. The maximal aortic diameter was 6±1 cm and indication for surgery included aortic arch aneurysms (n=5, 36%), penetrating arch ulcers (n=2, 14%), type B dissection with aneurismal arch involvement (n=3, 21%), residual arch dissections after ascending aortic repair (n=2, 14%) post-traumatic aneurysm (n=1, 7%) and type II TAAA with arch involvement (n=1, 7%). A total of 22 aortic arch vessels (brachiocephalic trunk=7, left common carotid artery=11, bovine arch=2, left subclavian artery (LSA)=2) were targeted. The left LSA was intentionally covered in 12 cases and preoperatively revascularized in 9. Successful endograft implantation was achieved in all cases. Two early postoperative deaths occurred (retroperitoneal hematoma and stroke=1, unclear cause=1). Further major complications included a major stroke with significant early clinical improvement, one delayed transient paraplegia and one vascular plug dislocation. The mean ICU and hospital stay was 3±2 and 11±8 days, respectively. At 8±7 months of follow-up the cumulative survival was 79% with no aneurysm-related death or re-
Vascular Annual Meeting 2014 • June 5 – 7, 2014 • Boston, Massachusetts
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