Postoperative In-Stent Thrombus Formation Following Frozen Elephant Trunk Total Arch Repair

Objectives: Our aim was to investigate the occurrence and clinical consequence of postoperative in-stent thrombus formation following the frozen elephant trunk (FET) procedure. Methods: Postoperative computed tomography angiography (CTA) scans of all 304 patients following the FET procedure between 04/2014 and 11/2021 were analysed retrospectively. Thrombus size and location were assessed in multiplanar reconstruction using IMPAX EE (Agfa HealthCare N.V., Morstel, Belgium) software. Patients' characteristics and clinical outcomes were evaluated between patients with and without thrombus formation. Results: = 0.023; OR: 5.198) were identified as significant predictors for thrombus development. Conclusion: Postoperative new thrombus formation within the FET stent-graft is a new, rare, but clinically highly relevant event. The embolisation of these thrombi can result in dismal postoperative outcomes. More research is therefore required to better identify patients at risk and improve perioperative treatment.