Endovascular arch replacement with a dual branched endoprosthesis

Area of Science:

• Vascular Surgery
• Interventional Cardiology
• Medical Device Technology

Background:

• Aortic arch pathologies pose significant risks with traditional open or hybrid repairs.
• Custom-made branched endovascular devices present an alternative to reduce operative mortality and morbidity.
• Limited single-center data exists for the Bolton double branch stent graft in aortic arch disease treatment.

Purpose of the Study:

• To evaluate the safety and efficacy of the Bolton custom-made branched stent graft for treating aortic arch disease.
• To report the single-center experience with this specific endovascular device in high-risk patients.

Main Methods:

• A retrospective analysis of nine high-risk patients with aortic arch pathology treated between 2013 and 2016.
• Seven patients treated with the Bolton double branch stent graft were included in the final analysis.
• Exclusion of two patients who received a single branch model.

Main Results:

• Two out of seven patients (28%) experienced perioperative mortality due to stroke and retrograde dissection.
• No further deaths, major complications, or secondary interventions were observed during a mean follow-up of 24 months.
• Aneurysmal diameter evolution and branch-related complications were not recorded in the remaining patients.

Conclusions:

• Endovascular repair using custom-made branched devices, like the Bolton stent graft, is a feasible option for high-risk patients with aortic arch disease.
• Results align with early experiences, suggesting this technique warrants consideration for suitable candidates.
• Further research with larger sample sizes is needed to confirm long-term outcomes.