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The Journal of Cardiovascular Surgery 2018 August;59(4):580-5

DOI: 10.23736/S0021-9509.16.09196-5


lingua: Inglese

Early evaluation of precise deployment with the new low-profile Zenith Alpha Thoracic Endoprosthesis in thoracic aortic disease

Bianca PANE, Giovanni SPINELLA , Maria C. PERFUMO, Debora MUSIO, Simone MAMBRINI, Cesare FERRERO, Valerio GAZZOLA, Domenico PALOMBO

Unit of Vascular and Endovascular Surgery, San Martino Institute for Cancer Research and Care, San Martino University Hospital, University of Genoa, Genoa, Italy


BACKGROUND: Endovascular treatment of thoracic aortic disease currently allows to treat high-risk patients with better results than open repair. It represents the first option for treatment according to the most recent guidelines. The aim of the study is to evaluate the early results of the low-profile Zenith Alpha Thoracic Endoprosthesis (ZATE).
METHODS: Between October 2012 and July 2015, 14 asymptomatic patients were treated with ZATE. 10 patients were male, mean age was 71, 7 years (range 58-85 years). 8 patients presented with atherosclerotic aortic aneurysm (7 thoracic aneurysm and 1 type I thoracoabdominal aneurysm), 2 chronic type B aortic dissection, 1 type IV endoleak 5 years after TEVAR, 3 aortic arch penetrating ulcers complicated by pseudoaneurysm. Hybrid staged procedures in 11 patients included 7 total aortic arch debranching (1 single [innominate] chimney stent-graft + carotid-carotid-subclavian), 2 carotid-carotid-subclavian artery bypass, 2 carotid-subclavian artery bypass.
RESULTS: No 30-day mortality or major complications were observed. The mean length of stay was 7.3 days (range 4-14 days). Mean procedure time, X ray time and Contrast load were 115 minutes (range 90-150 minutes), 20 minutes (range 10-30) and 79 mL (range 40-120 mL) respectively. 25 stent-grafts were implanted. The mean follow-up was 21 months (range 14-32 months). No mortality and no major complications were observed during the follow-up. In case of arch debranching with landing 0 and 1 zone the mean distance between the beginning of the endoprosthesis and the debranching inflow vessel was 5.5±2.4 mm.
CONCLUSIONS: The use of ZATE could be a viable alternative for treating patients with aortic arch proximal landing zone to facilitate the precise deployment. Larger case studies and longer follow-up are needed.

KEY WORDS: Thoracic aortic aneurysm - Endovascular procedures - Blood vessel prosthesis - Vascular grafting

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