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Objectives <p>Distal stent graft-induced new entry is a major complication after frozen elephant trunk procedure for type A acute aortic dissection. We investigated the impact of anastomosis location on this complication.</p> Methods <p>We reviewed 58 patients who underwent total arch replacement using frozen elephant trunk technique (2015–2023). Patients were divided by anastomosis location: Stent group (n = 24; anastomosis at stent part) and Fabric group (n = 34; anastomosis at graft part). We assessed early complications and mid-term distal aortic events during the follow-up.</p> Results <p>Patient characteristics were similar between groups. Early distal stent graft-induced new entry occurred in none of the Stent group versus 6 patients (18%) in the Fabric group (p = 0.04). Both groups showed similar false lumen thrombosis at arch and descending aorta. Freedom from distal aortic events at 1, 3, and 5&#xa0;years was 100%, 81%, 81% (Stent group) versus 79%, 67%, 33% (Fabric group) (p = 0.049).</p> Conclusions <p>Anastomosis at the stent part during frozen elephant trunk procedure reduced distal stent graft-induced new entry and improved mid-term outcomes. In distal anastomosis, the fabric should be as short as possible.</p>

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Stent part anastomosis reduces distal stent graft-induced new entry after frozen elephant trunk

  • 期刊论文

  • 发表日期：

    2025年6月25日

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  • Yoshinori Nakahara,
  • Akira Marui,
  • Tomohiro Iwakura,
  • Takeyuki Kanemura

摘要

Objectives

Distal stent graft-induced new entry is a major complication after frozen elephant trunk procedure for type A acute aortic dissection. We investigated the impact of anastomosis location on this complication.

Methods

We reviewed 58 patients who underwent total arch replacement using frozen elephant trunk technique (2015–2023). Patients were divided by anastomosis location: Stent group (n = 24; anastomosis at stent part) and Fabric group (n = 34; anastomosis at graft part). We assessed early complications and mid-term distal aortic events during the follow-up.

Results

Patient characteristics were similar between groups. Early distal stent graft-induced new entry occurred in none of the Stent group versus 6 patients (18%) in the Fabric group (p = 0.04). Both groups showed similar false lumen thrombosis at arch and descending aorta. Freedom from distal aortic events at 1, 3, and 5 years was 100%, 81%, 81% (Stent group) versus 79%, 67%, 33% (Fabric group) (p = 0.049).

Conclusions

Anastomosis at the stent part during frozen elephant trunk procedure reduced distal stent graft-induced new entry and improved mid-term outcomes. In distal anastomosis, the fabric should be as short as possible.