Clinical outcomes of total endovascular aortic arch repair by in situ microneedle fenestration using the triple (stiff)-sheathed gutter technique.
- 1Division of Vascular and Interventional Radiology, Department of General Surgery, Nanfang Hospital, Southern Medical University, No. 1838, North of Guangzhou Avenue, Guangzhou City, Guangdong Province, China.
- 2Department of Vascular Intervention, Shantou Central Hospital, Shantou, China.
- 3Division of Vascular and Interventional Radiology, Department of General Surgery, Nanfang Hospital, Southern Medical University, No. 1838, North of Guangzhou Avenue, Guangzhou City, Guangdong Province, China. [email protected].
Abstract
Purpose
To investigate the outcomes of total endovascular aortic arch repair (TEAAR) via in situ micro-needle fenestration (ISMNF) with the triple (stiff)-sheathed gutter technique.Materials and methods
In this retrospective study, the data of consecutive patients who underwent TEAAR via ISMNF with triple (stiff)-sheathed gutter technique between August 2022 and April 2025 were analyzed. Three 6-Fr, 90-cm sheaths were placed into ascending aorta without removing the dilator and super-stiff guidewires during main stent-graft deployment. This configuration creates a gutter between the stent-graft and aortic wall to maintain perfusion to supra-aortic branches. Operative details, technical success, 30-day and midterm outcomes, and adverse events were recorded. Kaplan-Meier analysis was used to estimate freedom from all-cause death and reintervention.Results
Overall, 36 patients were included. The technical success rate was 94.4% (34/36). Endovascular reconstruction of cervical branches was successfully performed in all cases. The 30-day mortality was 2.8%. The median follow-up period was 19 months (range, 1-32 months). The all-cause death rate was 11.1% (4/36), with no cases of any aorta-related death. The prevalence of endoleaks during follow-up was 13.9% (5/36). The overall stroke rate was 8.3% (3/36). The 1- and 2-year survival rates were 97.3% ± 2.7% and 85.8% ± 8.1%, respectively. The cumulative rate of freedom from reintervention at 1 and 2 years was 87.5% ± 5.9% and 83.2% ± 7.0%, respectively.Conclusion
TEAAR via ISMNF with the triple (stiff)-sheathed gutter technique was performed with a 94% technical success rate and stroke risk similar to open surgery.
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BibTeX
@article{ye2026clinical,
title = {{Clinical outcomes of total endovascular aortic arch repair by in situ microneedle fenestration using the triple (stiff)-sheathed gutter technique.}},
author = {Peng Ye and Hongfei Miao and Qingle Zeng and Wenya Liu and Mingyuan Ma and Yong Chen},
journal = {CVIR endovascular},
year = {2026},
month = oct,
doi = {10.1186/s42155-026-00788-3},
url = {https://europepmc.org/article/MED/42955600},
note = {CC BY},
}
RIS
TY - JOUR
TI - Clinical outcomes of total endovascular aortic arch repair by in situ microneedle fenestration using the triple (stiff)-sheathed gutter technique.
AU - Peng Ye
AU - Hongfei Miao
AU - Qingle Zeng
AU - Wenya Liu
AU - Mingyuan Ma
AU - Yong Chen
PY - 2026
DA - 2026/10/29
JO - CVIR endovascular
DO - 10.1186/s42155-026-00788-3
UR - https://europepmc.org/article/MED/42955600
AB - Purpose To investigate the outcomes of total endovascular aortic arch repair (TEAAR) via in situ micro-needle fenestration (ISMNF) with the triple (stiff)-sheathed gutter technique.Materials and methods In this retrospective study, the data of consecutive patients who underwent TEAAR via ISMNF with triple (stiff)-sheathed gutter technique between August 2022 and April 2025 were analyzed. Three 6-Fr, 90-cm sheaths were placed into ascending aorta without removing the dilator and super-stiff guidewires during main stent-graft deployment. This configuration creates a gutter between the stent-graft and aortic wall to maintain perfusion to supra-aortic branches. Operative details, technical success, 30-day and midterm outcomes, and adverse events were recorded. Kaplan-Meier analysis was used to estimate freedom from all-cause death and reintervention.Results Overall, 36 patients were included. The technical success rate was 94.4% (34/36). Endovascular reconstruction of cervical branches was successfully performed in all cases. The 30-day mortality was 2.8%. The median follow-up period was 19 months (range, 1-32 months). The all-cause death rate was 11.1% (4/36), with no cases of any aorta-related death. The prevalence of endoleaks during follow-up was 13.9% (5/36). The overall stroke rate was 8.3% (3/36). The 1- and 2-year survival rates were 97.3% ± 2.7% and 85.8% ± 8.1%, respectively. The cumulative rate of freedom from reintervention at 1 and 2 years was 87.5% ± 5.9% and 83.2% ± 7.0%, respectively.Conclusion TEAAR via ISMNF with the triple (stiff)-sheathed gutter technique was performed with a 94% technical success rate and stroke risk similar to open surgery.
SN - 2520-8934
ER -