Mid-term outcomes of left subclavian artery revascularization with Castor stent graft in treatment of type B aortic dissection in left subclavian artery

Yu Tian; Chengjie Wang; Peng Xie

doi:10.1016/j.jimed.2023.04.002

Mid-term outcomes of left subclavian artery revascularization with Castor stent graft in treatment of type B aortic dissection in left subclavian artery

J Interv Med. 2023 Apr 19;6(2):74-80. doi: 10.1016/j.jimed.2023.04.002. eCollection 2023 May.

Authors

Yu Tian¹, Chengjie Wang², Peng Xie³

Affiliations

¹ Department of Interventional Therapy, Cancer Hospital Chinese Academy of Medical Science, ShenZhen Center, Guangdong Province, China.
² Department of Vascular Surgery, Yuhuangding Hospital, Yantai, Shandong Province, China.
³ Department of Orthopedics, The 3rd Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong Province, China.

Abstract

Background: Here we analyzed mid-term data of thoracic endovascular aneurysm repair (TEVAR) surgery with Castor single-branched stent graft placement for the management of Stanford type B aortic dissection (STBAD) involving the left subclavian artery (LSA).

Methods: Between April 2014 and February 2019, 32 patients with STBAD involving a Castor single-branched stent graft were included. We analyzed their outcomes, including technical success rate (TSR), surgical duration (SD), presence of ischemia, perioperative complications, LSA patency, and survival rate (SR), using computed tomography angiography and clinical evaluation during mid-term follow-up.

Results: The mean patient age was 54.63 ± 12.37 years (range, 36-83 years). The TSR was 96.88% (n = 31/32). The mean SD was 87.44 ± 10.89 with a mean contrast volume of 125.31 ± 19.30 mL. No neurological complications or deaths occurred during the study period. The patients had a mean hospital stay of 7.84 ± 3.20 days. At a mean follow-up of 68.78 ± 11.26 months, four non-aortic deaths (12.5%) were observed. The LSA patency rate was 100% (n = 28/28). There was only one case of type I endoleak immediately after surgery (3.12%) (type I from LSA). However, none of the patients experienced type II endoleaks, and there were no cases of retrograde type A aortic dissection or stent graft-driven new distal entry. Finally, all patients exhibited good LSA patency.

Conclusion: TEVAR using a Castor single-branched stent graft may be a highly feasible and efficient procedure for the management of STBAD involving the LSA.

Keywords: Aortic dissection; Branched stent-graft; Endovascular treatment; Left subclavian artery.