Surgeon-modified fenestrated TEVAR using the Lifetech Ankura thoracic endograft achieved 100% technical success and 100% primary LSA patency over a mean follow-up of 51.9 months.
Observational (n=41)
No
Does surgeon-modified fenestrated TEVAR using the Lifetech Ankura endograft provide safe and effective outcomes in patients with thoracic aortic pathology requiring zone 2 landing?
Surgeon-modified fenestrated TEVAR using the Lifetech Ankura endograft is feasible and achieves high technical success and LSA patency for zone 2 landing.
AIM: Surgeon-modified fenestrated stent grafts (SMFSGs) have emerged to overcome limitations related to manufacturing delays, high procedural costs, anatomical constraints, and limited availability of custom-made branched or fenestrated endografts. The aim of this study was to evaluate the safety, feasibility, and mid- to long-term follow-up outcomes of the SMFSG technique for zone 2 landing using the Lifetech Ankura™ thoracic endograft. MATERIALS AND METHODS: Between January 2020 and January 2026, 41 consecutive patients with thoracic aortic pathology requiring zone 2 landing and left subclavian artery (LSA) revascularization using SMFSG with the Lifetech Ankura™ thoracic endograft (Lifetech Scientific, Shenzhen, China) were included in the study. No reinforcement sutures were used during graft modification. The primary and secondary endpoints were overall mortality, and aorta-related mortality (ARM), endoleak, patency of LSA, and reinterventions in the follow-up period. RESULTS: The mean age of the patient cohort was 58.2±11.2 (34-85) years. There was no open conversion to surgery and technical success was 100% according to the study definition. Eight patients (19.5%) underwent selective primary balloon-expandable stent placement in the LSA to optimize branch patency. Nine patients (21.95%) underwent the procedure under emergency conditions. The mean intensive care unit period was 14.8±7.1 hours (4-36 hours). The mean length of stay was 3.8±1.4 days (3-6 days). The fenestration procedure took a mean period of 11.3±3.2 minutes (8-18 minutes). The fluoroscopy period was 9.2±4.3 minutes (4-22 minutes). The follow-up period was 51.9±13.6 months (5 - 66 months). Primary and secondary LSA patency rates were 100% and 97.6% for the follow-up period. Two patients experienced Type 1a endoleak and both had TEVAR and Carotico-Subclavian bypass (CSB) at the 12 CONCLUSION: In this retrospective single-center series, surgeon-modified fenestrated TEVAR using the Lifetech Ankura thoracic endograft was feasible and achieved high technical success with favorable LSA patency and encouraging follow-up outcomes. However, interpretation is limited by the small sample size, heterogeneous pathology, and limited number of late events. Larger comparative studies are needed to better define durability and pathology-specific performance.
ISCAN et al. (Mon,) conducted a observational in Thoracic aortic pathology requiring zone 2 landing and left subclavian artery revascularization (n=41). Surgeon-modified fenestrated TEVAR using the Lifetech Ankura thoracic endograft was evaluated on Overall mortality, aorta-related mortality, endoleak, patency of LSA, and reinterventions. Surgeon-modified fenestrated TEVAR using the Lifetech Ankura thoracic endograft achieved 100% technical success and 100% primary LSA patency over a mean follow-up of 51.9 months.