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The Journal of Cardiovascular Surgery 2020 Nov 13

DOI: 10.23736/S0021-9509.20.11544-1

Copyright © 2020 EDIZIONI MINERVA MEDICA

language: English

Experience with physician-modified Ankura Endografts for endovascular repair of thoracoabdominal aortic aneurysms

Guangmin YANG, Ming ZHANG, Yepeng ZHANG, Tong QIAO, Min ZHOU , Xiaoqiang LI

Department of Vascular Surgery, Drum Tower Hospital, Affiliated to School of Medicine, Nanjing University, Nanjing, Jiangsu, China


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BACKGROUND: To evaluate the early results of fenestrated/branched endovascular aortic repair (F/B-EVAR) of thoracoabdominal aortic aneurysms (TAAAs) using physician-modified Ankura endografts (PMEGs).
METHODS: Sixteen consecutive patients who underwent F/B-EVAR using PMEGs between July 2017 and December 2018 were retrospectively reviewed. The perioperative mortality and morbidity of the PMEG technique were assessed, and the early results of follow-up were evaluated.
RESULTS: The median age of the patients was 75.3 years old (range, 48-83 years), and 12 (75.0%) patients were male. The median TAAA diameter was 7.1±1.5 cm (range 5.1-11 cm). The initial technical success rate of vessel revascularization was 98.2% (55 of 56). Target vessel patency was 98.1% (52/53), and freedom from reintervention was 98.1% (52/53) at follow-up. The 30-day mortality rates 6.3%. There was no death during follow-up.
CONCLUSIONS: In conclusion, PMEGs represent an important innovation, with favorable initial results, in the treatment of patients with complex TAAAs who may be unfit for open repair. In addition, they remain a promising option for high-risk patients in need of urgent repair who cannot wait for a custom-made device.


KEY WORDS: Fenestrated/branched endovascular aortic repair (F/B-EVAR); Physicianmodified endografts (PMEGs); Thoracoabdominal aortic aneurysms (TAAAs); Branches, fenestrations

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