Silent Brain Infarction After Endovascular Arch Procedures: Preliminary Results from the STEP Registry

ObjectiveFew data exist concerning the rate of silent cerebral ischaemic events following endovascular treatment aortic arch. The objective this work was to quantify these lesions using STEP registry (NCT04489277).MethodsThis multicentre retrospective cohort study included consecutive patients treated with an endoprosthesis deployed in Ishimaru zone 0–3 and brain diffusion weighted magnetic resonance imaging (DW-MRI) within seven days procedure. DW-MRI performed identify location number new infarctions (SBI). All endografts were carbon dioxide flushed prior implantation.ResultsThe population 91 (mean age, 69 years; men, 64%) from two academic centres between September 2018 January 2020. procedure elective 71 (78%). for a dissection, degenerative aneurysm, or other disease 44 (49%), 34 (37%), 13 (14%) patients, respectively. Endografts 0, 1, 2 3 23 (25%), 10 (11%), 47 (52%), 11 (12%) branched fenestrated (17%), tubular (58%). At 30 days, there no deaths clinical strokes. On DW-MRI, total 245 SBI identified 45 (50%). Lesions left hemisphere 63% (153/245), predominantly middle territory (94/245). Deployment 0–1 (p = .026), placement endograft .038), proximal diameter ? 40 mm urgent .005) significantly associated presence on univariable analysis, while found be independent predictor multivariable analysis (binary logistic regression) .002).ConclusionSBI repair arch is frequent, although Innovative strategies reduce risk embolisation need developed. Few (NCT04489277). This implantation. .002).