Practical experience with the TAG and conformable TAG devices: Lessons learned in about 100 cases

Aim. We reported our 10-year experience with the Gore TAG thoracic endoprosthesis for treatment of thoracic aorta pathologies. Methods. We performed a systematic retrospective study of prospectively recorded data of all patients who underwent thoracic endovascular aortic repair (TEVAR) procedure with Gore TAG thoracic endoprosthesis between January 2001 and March 2013, and conducted an analysis of patient demographics, periprocedural records, complications, reinterventions, and survival. Results. During this period, 96 patients underwent TEVAR with Gore TAG device. Indications for operation were degenerative aneurysm in 38 patients (39.6%), type B aortic dissection in 24 (25.0%), penetrating ulcer in 8 (8.3%), intramural hematoma in 10 (10.4%), traumatic transection in 9 (9.4%), and other pathology in 7 (7.3%). Forty-four patients (45.8%) had acute thoracic aortic syndromes requiring immediate or delaved procedures. Forty-two (43.8%) patients underwent supra-aortic trunks debranching. Landing zones were zone 0 in 8 patients (8.3%), zone 1 in 4 (4.2%), zone 2 in 36 (37.5%), zone 3 in 29 (30.2%) and zone 4 in 19 (19-8%). Technical success rate was 96.6%. Thirty-day mortality was 10.4%. Major adverse events included stroke in 8.3%, spinal cord ischemia in 4.2%, and vascular injuries in 7.3%. Overall survival in the cohort was 86% at 1 year and 78% at 2 years with a mean follow-up of 11.1±12.4 months. Major reintervention was required in 10 patients (10.4%). Conclusion. This single-center study demonstrates acceptable rates for operative mortality and major adverse events after endovascular repair of various thoracic aortic pathologies with both generations of Gore TAG device. However, a better knowledge in long-term results is necessary to define target populations.