Endovascular Treatment of Arterial Injuries with Bentleys Begraft Stent-graft System: Preliminary Results

Background: Arterial injuries can occur in a vast array of arterial beds with substantial morbidity and mortality. Endovascular therapy (embolization/covered stent) provides a minimally invasive and effective alternative to surgery. In the last decade, new more flexible peripheral stent-grafts have been developed. Differently from coils, stent-grafts allow for the exclusion of the lesion/defect without the sacrifice of the target vessel avoiding ischemic complications. The aim of our study is to evaluate the efficacy and the safety of begraft peripheral stent-graft for endovascular treatment of arterial injuries. Method(s): Between June 2015 and May 2018, 56 patients (mean age 66.7±14.8 y, 34 males) underwent emergency begraft stentgraft implantation for 60 arterial injuries. Twenty-one (37.5%) of these patients were haemodynamically unstable. The primary endpoints of this study were technical and clinical success, rates of minor and major complications. The secondary endpoint was the patency of the device during the follow-up. Result(s): Active bleeding was observed in 28 (50%) patients, pseudoaneurysms in 9 (16%), FAV in 2 (3.6%), an enteric-iliac fistula in 1 (1.8%) and dissection in 16 (28.6%). In all patients, the respective lesion or defect was effectively excluded by covered stent. Clinical success was documented in 55/56 patients (98.2%). Major complications included death in one patients (1.8%, not procedure-related) and rebleeding in another (1.8%, due to the progression of acute pancreatitis). Minor complications were reported in two patients (3.6%). After a mean FU of 511±325 (range 2-1100) days, total person-time 50 years, all the implanted devices are patent, corresponding to a rate of no patency ≤2x10-2 events per person-years (EPPY). Conclusion(s): The implantation of begraft peripheral stent-graft for the treatment of arterial injuries is minimally invasive and effective, with acceptable patency rate at the mid-term follow up. Larger cohort studies and longer follow up are needed to confirm these preliminary results.

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Artikel online veröffentlicht:
11. Mai 2021