Triple-Branched Stent-Grafts for Total Endovascular Repair of Aortic Arch Pathologies: A Systematic Review.
Hong-Cheng Luo, Kristine J S Kwan, Hai-Lei Li et al.
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In 30 seconds
This systematic review assessed early- and mid-term outcomes of triple-branched stent-grafts for total endovascular repair of aortic arch pathologies. Seven studies involving 194 patients met the inclusion criteria; eligible or separable data showed technical success in 97.8% (n = 136/139), 30-day mortality of 3.7% (n = 6/162), and stroke in 6.2% (n = 10/162). Reconstructed arch-branch patency was 100% during follow-up, while endoleak and reintervention remained notable. The authors considered the approach feasible in selected expert aortic centers, but identified neurologic complications and device durability as ongoing concerns.
Key findings
- Technical success was 97.8% (n = 136/139) across eligible or separable data.
- Thirty-day mortality was 3.7% (n = 6/162), and stroke occurred in 6.2% (n = 10/162).
- Endoleak occurred in 18/100 patients (18.0%); reintervention was performed in 26/155 patients (16.8%).
- Reconstructed arch-branch patency was 100% during follow-up; branch stenosis occurred in 2.4% (4/168) of target vessels.
Why it matters
The review brings together early clinical experience with a fully endovascular approach that reconstructs all three supra-aortic trunks. Its reported technical success and branch patency are encouraging, but stroke, endoleak, and reintervention show that procedural feasibility does not resolve important safety and durability questions. These outcomes help frame the balance of potential benefit and remaining uncertainty in selected patients treated at expert centers.
What to keep in mind
The evidence comprised seven studies and 194 patients, with outcomes drawn from eligible or separable data across reports. The abstract does not describe comparative evidence or long-term follow-up.