Mazzaccaro D, Avishay D, Nano G. Factors Affecting the Visceral Suitability of a Multibranched off-the-Shelf Endograft for the Treatment of Thoraco-Abdominal Aortic Aneurysms.
Ann Vasc Surg 2021;
81:113-120. [PMID:
34743010 DOI:
10.1016/j.avsg.2021.08.053]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Revised: 08/16/2021] [Accepted: 08/29/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND
To assess the factors affecting visceral suitability of the use of the Zenith T-branchTM system in a group of patients with thoraco-adbominal aortic aneurysms (TAAAs).
METHODS
Computer tomography angiography (CTA) of patients who presented a TAAA from 01/2015 to 12/2019 were retrospectively examined. Multi-Planar Reconstructions were performed on CTA images to assess the anatomic suitability of the Zenith T-branch in the visceral district. In particular, the branch deviation angle (BDA), and the branch-length were computed for each target vessel.
RESULTS
Fifty-four CTA were examined. In 33.3% of these patients the presence of either a common origin of the superior mesenteric artery and the celiac trunk, or the diameter of 1 or more visceral/renal artery limited the visceral suitability of the device. All patients except 1 (97.9%) fitted the BDA criterion when the graft was placed in a position in which the BDA for the SMA was 5 degrees to the left. The branch-length criteria was met in all patients, except for 1 (97.9%), when the graft was placed in the center of the aorta. The eccentrical placement of the endograft decreased the suitability to 93.7%.
CONCLUSIONS
The Zenith T-branch system can be suitable in the visceral district for about 67% of patients. The target artery diameter was the most limiting criterion. The central location of the graft within the aortic lumen significantly affected the branch-length distance criteria.
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