Proximal Scallop in XXXX Repair to Overcome Neck Issues in the Arch.

@entity1 @entity64 @entity449 @entity451 @entity1755 @entity1070 @entity2334 @entity583
OBJECTIVE: To evaluate initial experience with a custom made proximal scalloped stent graft for thoracic endovascular aortic repair (TEVAR) of @entity449 involving the arch. METHODS: Between September 2012 and November 2014, @entity1 presenting with a @entity2334 ( @entity2334 ) with short or angulated neck were selected for treatment by custom made proximal scalloped Relay Plus stent grafts (ABS Bolton Medical, Barcelona, Spain). Prospectively acquired data relating to @entity1 demographics, procedure details, clinical outcomes, and complications were analyzed retrospectively. RESULTS: Ten selected @entity1 (50% male, mean age 77      8 years) were treated using a thoracic custom made Relay Plus stent graft, three of whom underwent additional cervical supra-aortic trunk revascularizations. @entity2334 were fusiform in four cases, saccular in three, and three @entity1 were treated for proximal type I endoleaks after previous standard TEVAR. The graft was landed in zone 2 in 3 cases, in zone 1 in 4 cases, and in zone 0 in 3 cases. The custom made scallop was designed to preserve flow in the left subclavian artery in three @entity1 , in the left common carotid artery in four, and in the innominate artery in three. No proximal @entity1070 occurred and proximal sealing was achieved in all cases, with a technical success rate of 100%. All targeted vessels were patent. During a mean follow up of 12      5 months, no conversion to open surgical repair and no @entity1755 occurred. One @entity1 died post-operatively from @entity583 and one @entity1 suffered a @entity64 with complete recovery. One @entity1 had a distal @entity1070 on the 6 month CT scan and is scheduled for distal extension. No @entity451 , retrograde dissection and no other aortic related complications were recorded. CONCLUSIONS: Proximal scalloped stent grafts appear to be an effective additional tool for TEVAR of @entity2334 when dealing with short or angulated proximal necks.
