Early and Long Term Results of Viabahn Endograft for Treatment of Supra Aortic Trunks Aneurysm

Introduction: Evaluate early and long term results of Viab- han endograft in the treatment of supra aortic trunk (SAT) aneurysm. Methods: A retrospective study from 2009 to 2017 was conducted in our institution series. 13 patients matched the inclusion criteria in the indexed period. Patients character- istics, early and long term results were recorded in a dedicated database. Results: A total of 13 SAT aneurysms (three female and ten male patients) were treated: 8 of the subclavian artery, 2 of the internal carotid artery, 2 of the common carotid artery and one of the vertebral artery. Aetiology was post- traumatic in 4 cases (30%), in 2 (15%) was related to vasculitis, while in 7 (55%) was atherosclerotic. Indication for surgical treatment was dimension and presence of symptoms. Four patients (30%) experienced compression symptoms, six (46%) were treated in an emergency setting (3 for pain and 3 for rupture), while three patients (24%) were asymptomatic. All the subclavian artery aneurysms were treated through a surgical exposure of the ipsilateral brachial artery, while in the remaining patients a percutaneous femoral approach was performed (38%). Technical success was 100% and no early complications were recorded. In all cases the postoperative therapy consisted in a dual antiplatelet therapy (clopidogrel 75 mg and aspirin 100 mg) for six months followed by a single antiplatelet drug (aspirin 100 mg). Mean follow up was 3.5 years (1-8 years). We performed a duplex scan of the SAT at one, six and twelve months and then every year. Primary patency was 100%, one patient had an asymptomatic occlusion of the subclavian endograft after four years, while all the other endograft were patent at the last follow up. No cranial nerve injuries were re- ported and stroke free survival rate was 100%. No aneu- rysm- related death occurred. One patient died after three years due to pulmonary cancer.Conclusion: The Viabahn graft, even if it is considered off label for the treatment of supra aortic trunks aneurysms, provided, in our experience, acceptable early and long term results, due to its conformability and flexibility. In our opinion the endovascular approach with this type of stent graft is technically feasible with low complication rates.