Perioperative and Mid-term Outcomes of the Ankura Thoracic Stent Graft in Aortic Arch Pathologies With Open and Endovascular Perfusion of Supra-Aortic Branches: A Retrospective Review

BACKGROUND AND AIMS: This study reports on the perioperative and mid-term outcomes of a novel thoracic stent graft in aortic arch pathologies. METHODS: From January 2017 to May 2023, all patients treated with Ankura (Lifetech Scientific, Shenzhen, China) thoracic endograft combined with extra-anatomic and/or endovascular perfusion of supra-aortic branches at two university vascular centers were retrospectively reviewed. Indications for treatment included aneurysm, dissection, penetrating ulcer, intramural hematoma, traumatic rupture of the aortic arch and endoleak type Ia (Ia EL) of previous endovascular repair of the descending thoracic aorta. Perioperative and late causes of morbidity and mortality were captured. Patients' follow-up was obtained by computed tomography angiography at one month, six months, one year and then annually. The primary endpoint of the study was technical success, and secondary endpoints included aortic-related complications and all-cause mortality during follow-up. RESULTS: Aortic arch repair with Ankura thoracic endograft was performed in 30 patients. Mean age was 69.3 years (53-85 years), and male was the prevalent gender (25 patients, 83%). According to Ishimaru classification, Ankura stent graft was deployed at zone 2 in 21 patients (70%), at zone 1 in eight patients (26.6%) and at zone 0 in one patient (3.3%). Technical success was 94%. Type Ia EL was detected at two patients (6.6%). Perioperative morbidity and mortality were 6.6% and 3.3%, respectively. Mean follow-up was 22.03 months (range: 1-24 months). The aortic reintervention rate was 0%, and all-cause mortality was 16.6%. CONCLUSION: Ankura thoracic endograft showed satisfactory results with high technical success and low aortic-related complications in our study. Larger studies are necessary to establish the safety and efficacy of Ankura endograft in aortic arch pathologies.