Outcomes of hand-made versus commercial stent grafts in frozen elephant trunk

Objectives The frozen elephant trunk (FET) technique is effective for treating extended aortic arch aneurysms. This study compares hand-made and factory-made devices in this context. Methods A retrospective case-control study was conducted on 68 patients who underwent FET for distal aortic arch aneurysm at our institution. We used two different types of devices: hand-made stent graft in group Z (17 cases, 25.0%) and a commercialized stent graft in group J (51 cases, 75.0%). The study compared demographic characteristics and the outcomes between the two groups. Results In-hospital mortality was equivalent in both groups (5.9%). Spinal cord injury rates were 5.9% in group Z and 3.9% in group J. Group Z had a higher rate of aortic events (55.9% vs 96.9%, p < 0.001) and more frequent stent migration. The number of cases with aneurysm diameter shrinkage was lower in group Z. The landing zone angle at insertion influenced aneurysm changes, being 17.6 degrees in shrink cases and 26.7 degrees in unchanged or enlarged cases (p = 0.045). Conclusions FROZENIX device notably reduced incidences of postoperative complications compared to hand-made prostheses. Factors such as insertion angle and stent size, rather than changes in the landing zone angle, appeared to influence aneurysm shrinkage. The use of FROZENIX in TARFET procedures has shown benefits in reducing complications and improving long-term prognosis, taking into account the landing zone angle.