This study states that With the expanding application of endovascular technology, the need to deploy into zone 0 has been encountered on occasion. This study evaluated the outcomes of great vessel debranching (GVD) as a method of extending proximal landing zone to facilitate thoracic endovascular aortic repair (TEVAR).
A single-center retrospective review of all patients who underwent GVD followed by TEVAR between May 2013 and May 2020 was conducted. The primary outcome was primary patency of all targeted vessels, with mortality as a secondary outcome. Kaplan-Meier analysis was used to account for censoring in estimates of mortality and primary patency.There were 38 patients (20 men; mean age, 65 ± 14 years) who underwent GVD, with 110 vessels revascularized (38 innominate, 37 left common carotid, and 35 left subclavian; Table). Indications for TEVAR were type A dissection in 16 patients, type B dissection with aneurysmal degeneration in 12, thoracic aneurysm in 9, and perforated aortic ulcer in 1. Median duration between GVD and TEVAR was 38 days. Mean follow-up was 1.5 ± 1.8 years. Perioperative mortality, stroke, and paraplegia rates were 5.3%, 5.3%, and 2.6%, respectively. During the perioperative period, three endoleaks were identified, two of which required reintervention.
Reference link-https://www.jvascsurg.org/article/S0741-5214(20)31986-8/fulltext
