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THE JOURNAL OF CARDIOVASCULAR SURGERY

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The Journal of Cardiovascular Surgery 2016 Giugno;57(3):466-73

lingua: Inglese

TAArget versus EndoFit thoracic stent-grafts in thoracic endovascular aortic repair: a retrospective comparison of early and mid-term results in a single center

Ziheng WU 1, Lefeng QU 2, Kangkang ZHI 2, Hondkun ZHANG 1, Dieter RAITHEL 3

1 Department of Vascular Surgery the First Affiliated Hospital of Medical School of Zhejiang University, Hangzhou, China; 2 Department of Vascular Surgery, Changzheng hospital Second Military Medical University, Shanghai, China; 3 Department of Vascular and Endovascular Surgery Nuremberg Southern Hospital, Nuremberg, Germany


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BACKGROUND: Aim of the study was to compare our early and mid-term results using EndoFit and TAArget thoracic stent-grafts in thoracic endovascular aortic repair (TEVAR).
METHODS: We retrospectively reviewed 169 consecutive TEVAR cases (69.1±8.9 years) performed using the EndoFit or TAArget thoracic stent-grafts from December 2005 to January 2011 in our single center. Debranching procedures were needed in 111 (65.7%) cases before TEVAR. 87 (51.5%) patients who received EndoFit stent-graft between December 2005 and December 2007 were entered into Group A while the other 82 (48.5%) patients treated from January 2008 to January 2011 using TAArget stent-graft into Group B.
RESULTS: The technical success rate was 100% in both groups. 111 (65.7%) cases had 6 different debranching procedures prior to TEVAR to extend the proximal or distal landing zone. In group A, 5 cases had intraoperative proximal type I endoleak, while no occurrence in group B. The overall 30-day mortality rate was 5.3% (9/169), with statistical difference (Group A: 9.2%, 8/87 versus Group B: 1.2%, 1/82; P=0.049). Neurological complications occurred in 8 (4.7%) patients, all of the cases were in group A (8/87). There were 10 (6.3%) deaths recorded during the average of 29.0 months (range 15-42) follow-up period, all of the patients were in group A (Group A: 12.7%, 10/79 versus Group B: 0%, 0/81; P=0.003), no death was related to the aneurysm or the stent-graft. In Group A, 2 cases had post-TEVAR proximal type I endoleak.
CONCLUSIONS: Better clinical outcomes are highly dependent on accumulated learning curve and improved newer-generation devices and delivery systems. The second generation device TAArget’s new featuring uniform external fixation and TTTM Tortuous tracker delivery system allow better external fixation and precise deployment.

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qulefeng@gmail.com