E-vita OPEN NEO in the treatment of acute or chronic aortic pathologies: first interim results of the NEOS study

Eur J Cardiothorac Surg. 2024 Jun 3;65(6):ezae206. doi: 10.1093/ejcts/ezae206.

Abstract

Objectives: The aim of this multicentre study was to demonstrate the safety and clinical performance of E-vita OPEN NEO Stent Graft System (Artivion, Inc.) in the treatment of aneurysm or dissection, both acute and chronic, in the ascending aorta, aortic arch and descending thoracic aorta.

Methods: In this observational study of 12 centres performed in Europe and in Asia patients were enrolled between December 2020 and March 2022. All patients underwent frozen elephant trunk using E-vita OPEN NEO Stent Graft System. Primary end point was the rate of all-cause mortality at 30 days and secondary end points included further clinical and safety data are reported up to 3-6 months postoperatively.

Results: A total of 100 patients (66.7% male; mean age, 57.7 years) were enrolled at 12 sites. A total of 99 patients underwent surgery using the E-vita OPEN NEO for acute or subacute type A aortic dissection (n = 37), chronic type A aortic dissection (n = 33) or thoracic aortic aneurysm (n = 29), while 1 patient did not undergo surgery. Device technical success at 24 h was achieved in 97.0%. At discharge, new disabling stroke occurred in 4.4%, while new paraplegia and new paraparesis was reported in 2.2% and 2.2%, respectively. Renal failure requiring permanent (>90 days) dialysis or hemofiltration at discharge was observed in 3.3% of patients. Between discharge and the 3-6 months visit, no patients experienced new disabling stroke, new paraplegia or new paraparesis. The 30-day mortality was 5.1% and the estimated 6-month survival rate was 91.6% (standard deviation: 2.9).

Conclusions: Total arch replacement with the E-vita OPEN NEO can be performed with excellent results in both the acute and chronic setting. This indicates that E-vita OPEN NEO can be used safely, including in the setting of acute type A aortic dissection.

Keywords: Antegrade cerebral perfusion; Aortic arch aneurysm; Aortic dissection; Distal aortic perfusion; E-vita OPEN NEO; Frozen elephant trunk procedure.

Publication types

  • Observational Study
  • Multicenter Study

MeSH terms

  • Acute Disease
  • Adult
  • Aged
  • Aorta, Thoracic / surgery
  • Aortic Aneurysm, Thoracic* / mortality
  • Aortic Aneurysm, Thoracic* / surgery
  • Aortic Dissection* / mortality
  • Aortic Dissection* / surgery
  • Blood Vessel Prosthesis
  • Blood Vessel Prosthesis Implantation* / adverse effects
  • Blood Vessel Prosthesis Implantation* / methods
  • Chronic Disease
  • Endovascular Procedures / methods
  • Europe / epidemiology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Postoperative Complications / epidemiology
  • Stents
  • Treatment Outcome

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