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Updated: Aug 1, 2026
A New Murine Model of Endovascular Aortic Aneurysm Repair
Published on: July 7, 2013
Multicenter Experience With the Unitary Stent Graft System for Endovascular Debranched Aortic Repair of Various
Stevan S Pupovac1, Valentina Restrepo-Espinosa2, Julia Fayanne Chen3
1Division of Cardiac Surgery, Department of Surgery, Yale New Haven Health, New Haven, Connecticut; Northwell Health, New Hyde Park, New York.
Background:
This multicenter study analyzes the safety and feasibility of the unitary stent graft (USG) for endovascular debranched aortic repair (EDAR) of various complex thoracoabdominal aortopathies.
Methods:
EDAR was performed on 139 patients with thoracoabdominal aortic aneurysms at prohibitive risk for open surgery. Patients were included regardless of presentation, aneurysm/dissection extent, or spinal cord event history. The USG was assembled with the Medtronic Endurant II platform and Gore Viabhan stents to separate flow proximal to zone 6 into a visceral and an infrarenal limb, facilitating endoluminal bypasses to target mesenteric and renal vessels and infrarenal endovascular aneurysm repair. Two investigational device exemption databases (G140207 and G170036) and 1 presubmission database (Q222702) were prospectively maintained and retrospectively reviewed for mortality, 30-day major adverse events, technical success, and treatment success, assessed through clinical follow-up with imaging.
Results:
There were 2 short neck infrarenal aneurysms (1.4%), 2 type I (1.4%), 9 type II (6.5%), 6 type III (4.3%), 99 type IV (71.2%), and 3 type V (2.2%) Crawford thoracoabdominal aortic aneurysms, and 18 chronic dissections (12.9%). Technical success was 100%, with 98.7% primary and 99.8% secondary patency rates at 30 days. Thirty-day mortality was 3.6%. At a median follow-up of 360 days, target vessel patency rates were 97.2% (primary) and 98.6% (secondary), mortality rates were 23.0% (all-cause) and 3.6% (aneurysm-related). Major adverse events included paraplegia (0.7%), stroke (4.3%), bowel ischemia (2.9%), renal failure (1.4%), myocardial infarction (4.3%), and respiratory failure (15.8%). Median hospital stay was 7 days. Reintervention rate within 365 days was 3.6%.
Conclusions:
USG is a safe and effective option for EDAR of various thoracoabdominal aortopathies, including failed prior repairs, in patients at prohibitive risk for open surgery.
