Midterm Outcomes of BeGraft Stent Grafts Used As Bridging Stents in Fenestrated Endovascular Aortic Aneurysm Repair

Overview

Journal J Endovasc Ther

Publisher Sage Publications

Specialty Cardiology & Vascular Diseases

Date 2022 Apr 26

PMID 35471131

Authors

Rachel E Clough

Rafaelle Spear

Justine Mougin

Thomas Le Houerou

Dominique Fabre

Jonathan Sobocinski

Stephan Haulon

Affiliations

Soon will be listed here.

Abstract

Purpose: Fenestrated endovascular aneurysm repair (fEVAR) is established for the treatment of juxtarenal, pararenal, and thoracoabdominal aortic aneurysms (TAAAs). Bridging stents are used to connect the main body of the stent graft to the aortic branch vessels. Complications related to the bridging stents compromise the durability of the repair and require urgent re-intervention. Here we present the midterm results of the BeGraft stent graft system used for fEVAR.

Materials And Method: All consecutive patients treated with fEVAR and the current BeGraft Peripheral Stent Graft between November 2015 and September 2016 were included.

Results: Thirty-nine consecutive patients (38 men) were enrolled and 101 BeGraft second-generation stent grafts were implanted. The median aneurysm diameter was 60 mm (54.5-67.0 mm). Aneurysms were juxtarenal and pararenal (19/39, 48.1%), type 4 TAAA (3/39, 7.7%), type 1, 2, and 3 TAAA (7/39, 17.8%), type 5 TAAA (4/39, 10.2%), and 15.4% (6/39) had a type I endoleak following a previous EVAR. Fifty-five BeGrafts were implanted in mesenteric arteries (22 in coeliac trunks, 31 in the superior mesenteric artery, and 2 in a hepatic or splenic artery) and 46 into renal arteries (24 right and 22 left). The renal artery diameters were 5, 6, 7, and 8 mm in 9, 7, 26, and 4 patients, respectively. Mesenteric arteries were exclusively stented with 9 and 10 mm diameter devices. The median follow-up was 33 months (IQ25 17-IQ75 36). During follow-up, 11 patients died (28%) from non-aneurysm-related causes. The overall patency rates for bridging stents were 98% and 97% at 1 and 2 years, respectively, with a freedom from secondary procedure rate on BeGraft stent grafts of 96% (97/101). All events occurred on stents implanted in renal arteries.

Conclusion: Early favorable outcomes are confirmed during longer term follow-up. Vigilant surveillance is required.

Citing Articles

Analysis of Target Vessel Instability in Fenestrated Endovascular Repair (f-EVAR) in Thoraco-Abdominal Aortic Pathologies.

Becker D, Sikman L, Ali A, Mosbahi S, Prendes C, Stana J J Clin Med. 2024; 13(10).

PMID: 38792439 PMC: 11122549. DOI: 10.3390/jcm13102898.

References

Mastracci T, Carrell T, Constantinou J, Dias N, Martin-Gonzalez T, Katsargyris A . Editor's Choice - Effect of Branch Stent Choice on Branch-related Outcomes in Complex Aortic Repair. Eur J Vasc Endovasc Surg. 2016; 51(4):536-42. DOI: 10.1016/j.ejvs.2015.12.046. View

Tenorio E, Karkkainen J, Mendes B, DeMartino R, Macedo T, Diderrich A . Outcomes of directional branches using self-expandable or balloon-expandable stent grafts during endovascular repair of thoracoabdominal aortic aneurysms. J Vasc Surg. 2019; 71(5):1489-1502.e6. DOI: 10.1016/j.jvs.2019.07.079. View

Verhoeven E, Katsargyris A, Bekkema F, Oikonomou K, Zeebregts C, Ritter W . Editor's Choice - Ten-year Experience with Endovascular Repair of Thoracoabdominal Aortic Aneurysms: Results from 166 Consecutive Patients. Eur J Vasc Endovasc Surg. 2015; 49(5):524-31. DOI: 10.1016/j.ejvs.2014.11.018. View

Torsello G, Herten M, Muller M, Frank A, Torsello G, Austermann M . Comparison of the Biomechanical Properties of the Advanta V12/iCast and Viabahn Stent-Grafts as Bridging Devices in Fenestrated Endografts: An In Vitro Study. J Endovasc Ther. 2020; 27(2):258-265. DOI: 10.1177/1526602820908602. View

Spear R, Sobocinski J, Hertault A, Delloye M, Azzauiu R, Fabre D . One Year Outcomes of 101 BeGraft Stent Grafts used as Bridging Stents in Fenestrated Endovascular Repairs. Eur J Vasc Endovasc Surg. 2018; 55(4):504-510. DOI: 10.1016/j.ejvs.2018.01.023. View

Dossabhoy S, Simons J, Diamond K, Flahive J, Aiello F, Arous E . Reinterventions after fenestrated or branched endovascular aortic aneurysm repair. J Vasc Surg. 2018; 68(3):669-681. DOI: 10.1016/j.jvs.2017.12.036. View

Kotelis D, Schleimer K, Foldenauer C, Jalaie H, Grommes J, Jacobs M . Operative and Midterm Outcomes of the Fenestrated Anaconda Stent-Graft in the Endovascular Treatment of Juxtarenal, Suprarenal, and Type IV Thoracoabdominal Aortic Aneurysms. J Endovasc Ther. 2016; 23(6):930-935. DOI: 10.1177/1526602816667281. View

von Allmen R, Weiss S, Tevaearai H, Kuemmerli C, Tinner C, Carrel T . Completeness of Follow-Up Determines Validity of Study Findings: Results of a Prospective Repeated Measures Cohort Study. PLoS One. 2015; 10(10):e0140817. PMC: 4607456. DOI: 10.1371/journal.pone.0140817. View

Oderich G, Forbes T, Chaer R, Davies M, Lindsay T, Mastracci T . Reporting standards for endovascular aortic repair of aneurysms involving the renal-mesenteric arteries. J Vasc Surg. 2020; 73(1S):4S-52S. DOI: 10.1016/j.jvs.2020.06.011. View

10.

Martin-Gonzalez T, Mastracci T, Carrell T, Constantinou J, Dias N, Katsargyris A . Mid-term Outcomes of Renal Branches Versus Renal Fenestrations for Thoraco-abdominal Aneurysm Repair. Eur J Vasc Endovasc Surg. 2016; 52(2):141-8. DOI: 10.1016/j.ejvs.2016.03.018. View

11.

Huang I, Renani S, Morgan R . Complications and Reinterventions After Fenestrated and Branched EVAR in Patients with Paravisceral and Thoracoabdominal Aneurysms. Cardiovasc Intervent Radiol. 2018; 41(7):985-997. DOI: 10.1007/s00270-018-1917-0. View

12.

Eagleton M, Follansbee M, Wolski K, Mastracci T, Kuramochi Y . Fenestrated and branched endovascular aneurysm repair outcomes for type II and III thoracoabdominal aortic aneurysms. J Vasc Surg. 2016; 63(4):930-42. DOI: 10.1016/j.jvs.2015.10.095. View

13.

Oikonomou K, Kasprzak P, Schierling W, Kopp R, Pfister K . Graft Complexity-Related Outcomes of Fenestrated Endografting for Abdominal Aortic Aneurysms. J Endovasc Ther. 2017; 24(2):230-236. DOI: 10.1177/1526602817691752. View

14.

Sailer A, Wagemans B, Das M, de Haan M, Nelemans P, Wildberger J . Quantification of Respiratory Movement of the Aorta and Side Branches. J Endovasc Ther. 2015; 22(6):905-11. DOI: 10.1177/1526602815605325. View

15.

Farivar B, Brier C, Kuramochi Y, Eagleton M . Impact of bridging stent design and configuration on branch vessel durability after fenestrated endovascular repair of complex aortic aneurysms. J Vasc Surg. 2020; 73(3):819-825. DOI: 10.1016/j.jvs.2020.06.122. View

16.

Torsello G, Herten M, Frank A, Muller M, Jung S, Torsello G . Performance of BeGraft and BeGraft+ Stent-Grafts as Bridging Devices for Fenestrated Endovascular Aneurysm Repair: An In Vitro Study. J Endovasc Ther. 2019; 26(6):787-794. DOI: 10.1177/1526602819866435. View

17.

Torsello G, Herten M, Muller M, Frank A, Torsello G, Austermann M . In Vitro Evaluation of the Gore Viabahn Balloon-Expandable Stent-Graft for Fenestrated Endovascular Aortic Repair. J Endovasc Ther. 2019; 26(3):361-368. DOI: 10.1177/1526602819842569. View