Early and midterm outcomes of thoracic endovascular aortic repair with Lifetech Ankura™ thoracic endograft: A single tertiary center experience

Abstract

Aim: Thoracic aortic pathologies describe a wide spectrum of potentially life-threatening diseases almost always in a comorbid aged patient cohort. Thoracic endovascular aortic repair (TEVAR) is a less invasive treatment choice, offering reduced mortality and morbidity compared to open surgery. We decided to reveal our experience over safety and efficacy data with Lifetech Ankura™ Thoracic endografts with early and midterm outcomes, retrospectivelytiology. Material and Methods: Between January 2018 and January 2023, for a 5-year period, 203 patients who experienced TEVAR procedure with Lifetech Ankura™ Thoracic endograft were retrospectively evaluated. For the patients who required revascularization of the vessel branches originating from the aortic segments, all types of assistive techniques were performed. Intentional coverage of Left subclavian artery was also performed mostly in urgent patients. Results: 251 endografts were implanted in 203 patients. The most frequent aortic pathologies were the thoracic aortic fusiform aneurysm (56.6%) and type B aortic dissection (25.6%), respectively. Early (30-day/in-hospital) mortality occurred in 9 patients in total (4.4%). Technical success rate was 100%, and there was no conversion to open surgery. No other major adverse event, including cerebral, cardiac, or renal complication requiring dialysis, was observed. The average intensive care unit time was 16.9±11 hours (2-160), length of stay was 5.1±3.2 days. CSF drainage was performed in 51 patients inserted before the procedure prophylactically (25.1%). All patients who survived the operation were followed for 18.6±9.3 months. In the follow up period, four patients needed extension for endoleaks and two additive petticoat procedures were performed. One patient who had TEVAR due to a malperfused type B aortic dissection in the acute phase experienced RTAD 2 weeks after the initial procedure. Conclusion: TEVAR with LifeTech Ankura™ Thoracic Stent Graft system provides a safe, effective, and durable treatment with successful early outcomes and technical success. Wide spectrum in length and non-identical radiopaque proximal markers seem to facilitate some advanced endovascular skills. Long-term durability of the endograft should be tested.