{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T11:53:04Z","timestamp":1753876384998,"version":"3.41.2"},"reference-count":20,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2021,11,29]],"date-time":"2021-11-29T00:00:00Z","timestamp":1638144000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p\/>\n               <jats:sec>\n                  <jats:title>OBJECTIVES<\/jats:title>\n                  <jats:p>The aim of this study was to analyse outcomes of downstream thoracic endovascular aortic repair (TEVAR) following the frozen elephant trunk (FET) procedure.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>Sixty-six patients underwent downstream TEVAR following the FET procedure to treat thoracic aortic dissections (n\u2009=\u200942, 64%), aneurysms (n\u2009=\u200919, 29%) or penetrating aortic ulcers involving the aortic arch (n\u2009=\u20095, 8%). Patient and outcome characteristics were analysed.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>Downstream TEVAR was performed 7 [interquartile range: 2\u201318] months after the FET procedure in 39 male (59%) and 27 female (41%) patients aged 68 [interquartile range: 56, 75] years, including 11 patients (17%) with a connective tissue disease. Before TEVAR, cerebrospinal fluid drainage was put in place in 61 patients (92%). Patients were treated with 1 stent graft (n\u2009=\u200928, 42%), 2 stent grafts (n\u2009=\u200937, 56%) or 3 stent grafts (n\u2009=\u20091, 2%). The femoral artery was accessed through surgical cut-down (n\u2009=\u200915, 23%) or percutaneously (n\u2009=\u200949, 74%). One patient (2%) developed a temporary spinal cord injury that resolved spontaneously. No case of permanent spinal cord injury, stroke or death was observed. After 12 [interquartile range: 2\u201323] months, 15 patients required an additional aortic reintervention (endovascular: n\u2009=\u20096; surgical: n\u2009=\u20099).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>Downstream TEVAR following the FET procedure is associated with excellent clinical outcomes. We thus maintain that staging thoracic aortic repair\u2014FET and secondary TEVAR\u2014is a very successful and safe strategy. Certain patients might need a tertiary procedure to fix their entire aortic pathology; therefore, they will require long-term continuous follow-up, ideally in a dedicated aortic clinic.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/icvts\/ivab338","type":"journal-article","created":{"date-parts":[[2021,11,16]],"date-time":"2021-11-16T20:11:49Z","timestamp":1637093509000},"source":"Crossref","is-referenced-by-count":10,"title":["Downstream thoracic endovascular aortic repair following zone 2, 100-mm stent graft frozen elephant trunk implantation"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3099-7254","authenticated-orcid":false,"given":"Maximilian","family":"Kreibich","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Surgery, University Heart Centre Freiburg, Faculty of Medicine, Albert-Ludwigs-University of Freiburg, Freiburg, 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