Clinical application of 3D parametric surface planar topological guide plate in fenestrated/branched endovascular aortic repair technique

Objective To summarize the experience and effect using 3D parametric surface planar topological guide plate technology in fenestrated/branched endovascular aortic repair (F/B EVAR) to repair aortic arch and thoracoabdominal aortic lesions involving important aortic branches. Methods From August 2020 through April 2022, 17 patients [14 males and 3 females, mean age of(61.06±11.23)(39-78) years] with complex aortic lesions involving important branches were treated in both Nanjing Drum Tower Hospital and Union Hospital. There were 8 cases with aortic arch aneurysms 4 cases and dissections 4 cases, respectively, and 9 cases with thoracoabdominal aortic aneurysms 5 cases and dissections 4 cases, respectively. Six cases were urgent operation and 11 cases were selective operation. Before operation, 3D parametric surface planar topological guide plate was made according to aortic computed tomography angiography. Under the guidance of planar guide plate, pre-fenestrated and external/internal branched and other endovascular aortic repair was performed. Totally, 50 fenestrated/branched stent grafts were planted. Results All operations were completed without conversion to open surgery. Average operative time was (4.57±2.29)(1.50-10.67) h. There was no renal insufficiency, paraplegia and loss of branch arteries. One patient (5.88%) died during perioperative period. Within the follow-up, there were 2 cases (11.76%) of endoleak type Ⅰc and type Ⅲc, respectively. Conclusions F/B EVAR under the guidance of 3D parametric surface planar topological guide plate is a minimally invasive treatment. The technology is more accurate than traditional measurement and positioning, faster than 3D printing guidance, and safe and reliable shown in the follow-up.