Early Lessons Learned After Our First Implantations of an Off-the-Shelf Single-Branch TEVAR
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ID: 315765
2026
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Abstract
Abstract Background Thoracic endovascular aortic repair (TEVAR) involving the proximal descending thoracic aorta often requires coverage of the left subclavian artery (LSA), which may increase the risk of stroke or upper limb ischemia. Off-the-shelf single-branch TEVAR devices offer an alternative to surgical debranching or custom-made grafts, particularly in urgent settings. Aims To evaluate early clinical outcomes, technical feasibility, and intraoperative challenges during initial implantations of an off-the-shelf single-branch TEVAR device. Methods A retrospective single-center case series was conducted including consecutive patients treated with single-branch TEVAR between January and September 2025. Patient characteristics, procedural details, intraoperative events, and early postoperative outcomes were analyzed. Follow-up included in-hospital and three-month outcomes. Results Twelve patients were included (mean age 68 years) and 67% were female (Figure.1). Indications comprised thoracic aortic aneurysm (50%), aortic dissection (33%), intramural hematoma with aneurysm (8%), and penetrating aortic ulcer (8%) (Figure.2). Technical success was achieved in all cases. Mean procedure time was 110 minutes, and mean hospital stay was 7 days. Cerebrospinal fluid drainage was used in one third of patients. Two intraoperative device- or access-related complications occurred and were successfully managed endovascularly or surgically. Femoral access closure failure occurred in four patients and was treated with additional closure devices. One patient experienced a transient posterior stroke with complete neurological recovery, and one patient developed transient paraparesis following a secondary endovascular procedure. No reinterventions or 30-day mortality occurred. LSA branch patency was 100%, and three-month follow-up was uneventful apart from one minor access-site hematoma. Conclusion Early experience with off-the-shelf single-branch TEVAR demonstrates high technical success and favorable short-term outcomes. Immediate device availability represents a major advantage in urgent cases. Awareness of device-specific and access-related complications is essential during the initial learning phase. Further studies with longer follow-up are required to assess long-term durability and branch patency.For image description, please refer to the figure legend and surrounding text. For image description, please refer to the figure legend and surrounding text. For image description, please refer to the figure legend and surrounding text.
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openalex_W7163405449
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| Authors | H Ceyran, E Mujagic |
| Journal | the british journal of surgery |
| Year | 2026 |
| DOI |
10.1093/bjs/znag055.069
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| URL | |
| Keywords | Keywords not found |
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