Reintervention
Finally, it is worth considering the relative risk of patients having to undergo subsequent procedures following FET arch repair. One primary advantage of the FET procedure over conventional ET prosthesis is the drastically reduced incidence of reintervention after the initial procedure.4 While it is challenging to directly attribute the need for reintervention to differences between Z-0-FET and Z-2-FET, it is likely that the need for reintervention is linked to the degree of positive aortic remodelling and FL thrombosis following prosthesis implantation.25 It appears that Z-0-FET may be associated with lower rates of reintervention than Z-2-FET: while Yamamoto et al. highlight 7 cases of thoracic endovascular aortic repair (TEVAR) attributed to FL enlargement (n=2), TL stenosis (n=3), proximal anastomotic rupture (n=1), and bowel resection (n=1), 12% (n=19) of patients in Jakob and colleague’s Z-2-FET report underwent aortic reintervention due to disease progression.16, 23 A further 7% (n=7) of patients in Beckmann’s trial underwent subsequent aortic replacement.12