Orthotopic branched endovascular aortic arch repair in patients who cannot undergo classical surgery

OBJECTIVES: Our goal was to assess the results after orthotopic branched endovascular aortic arch repair using a new double-branch endoprosthesis in patients with thoracic aortic disease affecting the aortic arch who cannot undergo classical surgery. METHODS: Within a 4-year period, 15 patients with thoracic aortic disease affecting the aortic arch were treated with the Bolton Relay plus double-branch endoprosthesis (Bolton Medical, Sunrise, FL, USA) We assessed clinical outcome, occurrence of endoleaks and the need for secondary interventions The median logistic EuroSCORE I level was 13.6 (4.2.; 22.8) RESULTS: The in-hospital mortality rate was 6 .7% A disabling stroke was observed in 1 (6.7%) patient, whereas non-disabling strokes occurred in 2 (13.3%) patients Type I and III endoleaks occurred in 6.7% The median follow-up period was 263 (1st quartile 84; 2nd quartile 564) days Four patients died during the follow-up period Aortic-related survival was 100%. CONCLUSIONS: Orthotopic branched endovascular aortic arch repair using the Bolton Relay Plus double-branch endoprosthesis is a safe and feasible technique enriching the armamentarium to treat patients with thoracic aortic disease who cannot undergo classical surgery Aortic-related survival is excellent, and the occurrence of disabling stroke and endoleaks warranting treatment is low Further studies are needed to assess the long-term durability of this new method.