Research on Individualized Brain Protection Strategies in Three-Branched Fenestrated Endovascular Aortic Arch Repair
Keywords:
aortic arch disease, three-branched fenestration, brain protection, anterograde cerebral perfusion, individualized strategyAbstract
This research aimed to present and evaluate an individualized brain protection strategy for reducing perioperative ischemic stroke during three-branched fenestrated endovascular aortic arch repair. This research was survey research by retrospective design. The study population consisted of 21 patients with aortic arch disease who underwent thoracic endovascular aortic repair (TEVAR) combined with three-branched fenestration at the Department of Vascular Surgery, the Fourth Affiliated Hospital of Guangxi Medical University, between January 2017 and January 2024. The research instruments included clinical data record forms, transcranial Doppler ultrasonography (TCD), an extracorporeal circulation system, and computed tomography angiography (CTA). Data were collected from medical records and follow-up of at least 12 months. Data were analyzed using descriptive statistics, with categorical data presented as frequencies and percentages, and continuous data as mean ± standard deviation.
The findings revealed a 100% technical success rate, no perioperative mortality, and no symptomatic cerebral ischemia. Two patients (9.5%) had asymptomatic cerebral infarction, and two (9.5%) experienced access-related complications. The mean anterograde cerebral perfusion time was 102.0 ± 11.0 minutes. During follow-up, no new strokes occurred; four patients (19.05%) had endoleaks, and two (9.5%) developed branch stent occlusion. One patient died from retrograde aortic dissection.
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