Novel Nitinol Endovascular Stent Graft System For Thoracic Aortic Pathologies: A Comparative Study
SZE YUEN Peter YU, Chi Ying Simon Chow, Yan Kit Jacky Ho, Wai Ting Micky Kwok, Yuk Pui Innes Wan, Cheuk Man Chu, Chun Ho Simon Yu, Malcolm John Underwood, Hung Leung Randolph Wong.
The Chinese University of Hong Kong, Hong Kong, Hong Kong.
BACKGROUND: The RELAY NBS [Bolton Medical, Florida, USA] is a new nitinol stent graft system designed specifically for the thoracic aorta. Its performance and efficacy compared to the other stent graft systems have not been studied.
METHODS: A retrospective study on the use of RELAY NBS stent graft system, compared to the other stent graft systems, for elective treatment of native thoracic aortic pathologies was conducted. Patients with emergency operation, Zone 0 landing or landing into non-native aorta were excluded. The primary outcome of study is the composite adverse outcome of on-table reintervention of technical complications (severe type 1a endoleak or stent retroflexion), aorta-related mortality, stent-related complications on computer tomography scan follow-up, and aortic reinterventions.
RESULTS: From August 2008 to July 2017, 68 consecutive patients with thoracic aortic pathologies managed by elective endovascular stent graft repair were divided into two groups (RELAY NBS: N=33, 48.5%; Other systems: N=35, 51.5%). The vascular risk factor profile and intraoperative parameters were similar except for more percutaneous vascular access for the RELAY NBS group (93.9% vs. 42.9%, p < 0.001). Use of RELAY NBS system was associated with less primary composite adverse outcomes (3.0% vs. 25.7%, p=0.014), less on-table reintervention of technical complications (0 vs. 11.4%, p=0.045), less stent-induced new entry (0 vs. 15.2%, p=0.020), and a trend of less stent-related complications on follow-up computer tomography scan (9.1% vs. 24.2%, p=0.093). The incidence of stroke (3% vs. 0, p=0.485), paraplegia (3% vs. 0, p=0.485), peripheral vascular complications (3% vs. 2.9%, p=1.000), 30-day mortality (0 vs. 5.7%, p=0.493) and aorta-related mortality (0 vs. 2.9%, p=1.000) were similar between the two groups.
CONCLUSIONS: Endovascular stent graft repair with the new RELAY NBS system for thoracic aorta pathologies was associated with less major perioperative and long-term adverse outcomes compared to the traditional systems.
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