Research published in Journal of Endovascular Therapy shows that early results are promising for use of the first off-the-shelf multibranched stent in aneurysm patients. Five months after receiving this treatment, a small group of patients has survived and remained free of rupture. Although custom-made devices have been available for more than a decade, these readily available “t-Branch” stents reportedly offer greater resources for treatment of thoracoabdominal aortic aneurysm.
The current issue of the Journal of Endovascular Therapy presents a retrospective review of 15 patients who were implanted with the Zenith t-Branch stent. The stent has four downward facing branches and can be combined with a number of individual components, such as tapered thoracic endografts and universal distal bodies. Previous study has shown that a standardised endograft would be suitable for nearly 88 percent of patients with thoracoabdominal aortic aneurysms.
The aorta delivers blood from the heart to the rest of the body. A thoracoabdominal aortic aneurysm—a weakness in the wall of the aorta—can rupture, causing uncontrolled bleeding that can be fatal if not treated immediately. A complex surgical procedure, open repair of thoracoabdominal aortic aneurysms, has been associated with high mortality and morbidity. Since their introduction 13 years ago, custom-made multi-branched endografts have been proven to reduce mortality and morbidity among aneurysm patients. However, these customised stents require manufacturing times of at least eight weeks, making them unavailable when a patient needs urgent treatment. One year ago, the first commercially made off-the-shelf thoracoabdominal t-Branch became available in Europe.
Among the 15 patients treated with this t-Branch stent between November 2012 and May 2013, none have died, and no branch occlusion or type I or III endoleaks have occurred. Type II endoleaks were observed in five patients, one patient suffered paraplegia, and four patients experienced transient paraparesis that was resolved. These short-term results indicate that use of an off-the-shelf t-Branch endograft is practicable and safe.
An accompanying commentary suggests some improvements or alternate versions of a standardised t-Branch stent that may help resolve certain issues. The author notes that the design is still evolving, and time will tell which stent approach best meets treatment needs.
EH News Bureau
