Three Year Data on the Performance of Three Renal Artery Bridging Stent Grafts in Branched Endovascular Repair of Thoraco-Abdominal Pathologies

IF 6.8 1区医学 Q1 PERIPHERAL VASCULAR DISEASE European Journal of Vascular and Endovascular Surgery Pub Date : 2025-09-01 Epub Date: 2025-02-25 DOI:10.1016/j.ejvs.2025.02.034

Rebecca Kolet , Marco Virgilio Usai , Yousef Shehada , Bärbel Berekhoven , Veronika Weyer-Elberich , Martin Austermann

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Abstract

Objective

Previous studies have shown that branched endovascular aneurysm repair (B-EVAR) carries a significant risk of adverse renal events. The purpose of this study was to evaluate the performance of the balloon expandable covered stentgraft (BECS) Advanta/iCast V12, the Viabahn balloon expandable stent (VBX), and the BECS Advanta stent combined with a distally deployed self expanding covered stentgraft (SECS) Viabahn (VSX) as bridging stent grafts (BSGs) in renal arteries.

Methods

A retrospective analysis of prospectively collected data was conducted at a single centre. Patients undergoing B-EVAR who had at least one Advanta, Advanta + VSX, or VBX as renal artery BSGs were included. Endpoints were patency, endoleaks, target vessel instability (TVI), re-interventions, as well as clinical outcomes including kidney function, new dialysis needs, and death. Data were analysed using Kaplan–Meier estimates and multivariable Cox regression.

Results

The study included 255 patients with 431 renal artery BSGs treated by complex aortic repair between 2010 and 2019. Advanta was used predominantly in 2010 – 2014, Advanta + VSX in 2015 – 2017, and VBX in 2018 – 2019. Overall, 125 Advanta, 146 Advanta + VSX, and 160 VBX stents were implanted. The median follow up was 19.3 months. At three years, estimated primary patencies were 82.7 ± 4.6% for renal arteries treated with Advanta, 96.8 ± 1.8% for Advanta + VSX, and 89.0 ± 3.2% for VBX. Estimated freedom from TVI at three years was 82.4 ± 4.7% for renal arteries treated with Advanta, 94.1 ± 2.4% for Advanta + VSX, and 85.4 ± 3.5% for VBX. Freedom from re-intervention estimations at three years were 86.3 ± 3.4% in the Advanta cohort, 95.1 ± 2.0% in the Advanta + VSX cohort, and 91.6 ± 2.4% in the VBX cohort.

Conclusion

The combination of BECS and SECS seems to be superior in terms of primary patency compared with BECS alone.

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三种肾动脉桥接支架在胸腹病变分支血管内修复中的三年数据。

目的：以往的研究表明，支状血管内动脉瘤修复术（BEVAR）具有显著的肾脏不良事件风险。本研究的目的是评价球囊可扩张覆盖支架（BECS Advanta/iCast V12）、Viabahn球囊可扩张支架（VBX）和BECS Advanta联合远端部署自扩张覆盖支架（SECS） Viabahn （VSX）作为肾动脉桥接支架（BSGs）的性能。方法：在单个中心对前瞻性收集的资料进行回顾性分析。接受BEVAR的患者在肾动脉中至少有一种爱德华、爱德华+ VSX或VBX作为BSG。终点是通畅、内漏、靶血管不稳定（TVI）、再干预，以及包括肾功能、新透析需求和死亡在内的临床结果。数据分析采用Kaplan-Meier估计和多变量Cox回归。结果：该研究纳入了2010年至2019年期间接受复杂主动脉修复治疗的255例肾动脉431 BSGs患者。2010 - 2014年主要使用的是Advanta， 2015 - 2017年主要使用的是Advanta + VSX， 2018 - 2019年主要使用的是VBX。总共植入125例Advanta， 146例Advanta + VSX， 160例VBX。中位随访时间为19.3个月。三年时，经爱德华治疗的肾动脉组的原发性通畅率为82.7±4.6%，爱德华+ VSX组为96.8±1.8%，VBX组为89.0±3.2%。三年后肾动脉TVI的估计自由度为：Advanta组82.4±4.7%，Advanta + VSX组94.1±2.4%，VBX组85.4±3.5%。三年后再干预自由度在Advanta组为86.3±3.4%，在Advanta + VSX组为95.1±2.0%，在VBX组为91.6±2.4%。结论：在原发性通畅方面，BECS联合SECS优于BECS单用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Journal of Vascular and Endovascular Surgery 医学-外科

CiteScore

6.80

自引率

15.80%

发文量

471

审稿时长

66 days

期刊介绍： The European Journal of Vascular and Endovascular Surgery is aimed primarily at vascular surgeons dealing with patients with arterial, venous and lymphatic diseases. Contributions are included on the diagnosis, investigation and management of these vascular disorders. Papers that consider the technical aspects of vascular surgery are encouraged, and the journal includes invited state-of-the-art articles. Reflecting the increasing importance of endovascular techniques in the management of vascular diseases and the value of closer collaboration between the vascular surgeon and the vascular radiologist, the journal has now extended its scope to encompass the growing number of contributions from this exciting field. Articles describing endovascular method and their critical evaluation are included, as well as reports on the emerging technology associated with this field.