Downstream thoracic endovascular aortic repair following zone 2, 100-mm stent graft frozen elephant trunk implantation

Abstract: OBJECTIVES
The aim of this study was to analyse outcomes of downstream thoracic endovascular aortic repair (TEVAR) following the frozen elephant trunk (FET) procedure.

METHODS
Sixty-six patients underwent downstream TEVAR following the FET procedure to treat thoracic aortic dissections (n = 42, 64%), aneurysms (n = 19, 29%) or penetrating aortic ulcers involving the aortic arch (n = 5, 8%). Patient and outcome characteristics were analysed.

RESULTS
Downstream TEVAR was performed 7 [interquartile range: 2–18] months after the FET procedure in 39 male (59%) and 27 female (41%) patients aged 68 [interquartile range: 56, 75] years, including 11 patients (17%) with a connective tissue disease. Before TEVAR, cerebrospinal fluid drainage was put in place in 61 patients (92%). Patients were treated with 1 stent graft (n = 28, 42%), 2 stent grafts (n = 37, 56%) or 3 stent grafts (n = 1, 2%). The femoral artery was accessed through surgical cut-down (n = 15, 23%) or percutaneously (n = 49, 74%). One patient (2%) developed a temporary spinal cord injury that resolved spontaneously. No case of permanent spinal cord injury, stroke or death was observed. After 12 [interquartile range: 2–23] months, 15 patients required an additional aortic reintervention (endovascular: n = 6; surgical: n = 9).

CONCLUSIONS
Downstream TEVAR following the FET procedure is associated with excellent clinical outcomes. We thus maintain that staging thoracic aortic repair—FET and secondary TEVAR—is a very successful and safe strategy. Certain patients might need a tertiary procedure to fix their entire aortic pathology; therefore, they will require long-term continuous follow-up, ideally in a dedicated aortic clinic

Object Details

• Location: Deutsche Nationalbibliothek Frankfurt am Main
• Extent: Online-Ressource
• Language: Englisch
• Notes: Interactive cardiovascular and thoracic surgery. - 34, 6 (2022) , 1141–1146, ISSN: 1569-9285

Contributors, Places and Time

• Event: Veröffentlichung
• (where): Freiburg
• (who): Universität
• (when): 2024
• Creator: Kreibich, Maximilian ; Siepe, Matthias ; Berger, Tim ; Kondov, Stoyan ; Morlock, Julia ; Pingpoh, Clarence Pienteu ; Beyersdorf, Friedhelm ; Rylski, Bartosz ; Czerny, Martin

Further information

• DOI: 10.1093/icvts/ivab338
• URN: urn:nbn:de:bsz:25-freidok-2229889
• Rights: Open Access; Der Zugriff auf das Objekt ist unbeschränkt möglich.
• Last update: 15.08.2025, 7:35 AM CEST