Distal Endovascular Extension After FET: Short and Mid-Term Outcome in a High-Volume Single-Center Experience

Area of Science:

• Cardiovascular Surgery
• Endovascular Aortic Repair
• Thoracic Aortic Disease

Background:

• Frozen elephant trunk (FET) procedures are complex interventions for thoracic aortic pathologies.
• Investigating outcomes of distal endovascular extensions following FET is critical for patient management.

Purpose of the Study:

• To evaluate the results and outcomes of distal endovascular extensions after FET repair.
• To compare outcomes between aneurysm and dissection patient groups.

Main Methods:

• A retrospective study included 29 patients undergoing thoracic endovascular aortic repair (TEVAR) or thoraco-abdominal repair (TAA-EVAR) after FET.
• Patients were categorized into 'Aneurysm' or 'Dissection' groups.
• Primary endpoints were technical success and early reintervention; secondary endpoints included survival rates.

Main Results:

• High technical success was achieved for both primary TEVAR and secondary TAA-EVAR extensions.
• No 30-day mortality or reinterventions were observed.
• 36-month freedom-from-reintervention was 72% (aneurysm) and 64% (dissection).
• Overall survival rates were high (91.7% and 100% at 36 months).

Conclusions:

• Distal endovascular extensions post-FET are feasible with low perioperative risks.
• While technically successful, aortic-related reinterventions remain a concern.
• Close patient surveillance is recommended after these procedures.