Total arch TEVAR with outside (on-a-table) and in situ fenestration (F-TEVAR): first results
Abstract
Background. Over the past 20 years, there has been a clear shift
towards endovascular repair of the thoracic aorta in its various pathologies.
However, complete endovascular repair of the aortic arch remains technically
sophisticated. Currently, there are several methods of endovascular arch
treatment: a hybrid approach, total endovascular debranching using parallel
grafts (like a chimney or snorkeling) and fenestration (factory-made, hand-made
(physician modified graft [PMG]) in-situ or outside [on-a-table]). The
first results of the application of the aortic arch repair technology are
promising, especially the complete replacement of the aortic arch by means of
non-standard fenestrated or branched stent grafts.
Use of fenestrated or
branched grafts factory FTEVAR and Chimney is an attractive method for treating
aortic arch diseases but they have higher cost and longer waiting time.
Aim. To improve the outcome of surgical treatment of
patients with aortic arch pathology.
We introduce for your
consideration several cases of hybrid endovascular repair of the total aortic
arch and side-branches in patients with type A aortic dissection (according to
Stanford classification) using the “outside”(on-a-table) and “in-situ”
techniques of graft fenestration, as well as first demonstrate the long-term
results of the Russian Federation.
Keywords:aortic dissection; outside and in situ; fenestration; aortic arch; total arch; stent-graft; FTEVAR; TEVAR; physician modified graft (PMG)
Funding. The study had no sponsor support.
Conflict of interest. The authors declare no conflict of interest.
For citation: Akhmedov U.U., Sharafutdinov M.R., Yakubov R.A.,
Sadykov R.Z., Khayrutdinov A.I., Tarasov Yu.V., Mukhamadeev M.F. Total arch
TEVAR with outside (on-a-table) and in situ fenestration (F-TEVAR):
first results. Clinical and Experimental Surgery. Petrovsky Journal. 2022; 10
(4): 12–5. DOI: https://doi.org/10.33029/2308-1198-2022-10-4-12-15
(in Russian)
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