Frontiers in Cardiovascular Medicine (Aug 2023)

Endovascular repair of thoracic aortic disease with isolated left vertebral artery and unfavorable proximal landing zone using fenestrated castor stent-graft

  • Zhenhua Wang,
  • Zhenhua Wang,
  • Changcun Fang,
  • Changcun Fang,
  • Han Song,
  • Han Song,
  • Duoliang Wei,
  • Duoliang Wei,
  • Xiangbin Meng,
  • Xiangbin Meng,
  • Xiao Bai,
  • Xiao Bai,
  • Chunxiao Liu,
  • Chunxiao Liu,
  • Xin Zhao,
  • Xin Zhao

DOI
https://doi.org/10.3389/fcvm.2023.1168180
Journal volume & issue
Vol. 10

Abstract

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ObjectiveThe main purpose of this study was to evaluate the safety and efficacy of Castor single-branched stent-graft combined with fenestrated technique in treatment of thoracic aortic disease (TAD) with unfavorable proximal landing area (PLZ) and isolated left vertebral artery (ILVA).MethodsFrom January 2018 to March 2022, 8 patients with TAD (6 patients with type B aortic dissections, 1 patient with type B intramural hematomas, and 1 patient with thoracic aortic aneurysm) underwent thoracic endovascular aortic repair with fenestrated Castor stent-graft due to the existence of ILVA and unfavorable PLZ. Demographic characteristics, surgical details, postoperative complications, follow-up and postoperative CTA imaging results were collected and analyzed.ResultsThe primary technical success rate was 100%. The mean operation time was 115 min (range, 70–180 min). All the left subclavian arteries (LSAs) and ILVAs of the eight patients were revascularized by fenestrated Castor stent-grafts. During the follow-up period, no deaths and complications were observed. No internal leakage, aortic rupture, retrograde type A dissection were found on computed tomography angiography. All of the LSAs and ILVAs maintained patency without stenosis.ConclusionCastor single-branched stent-graft implantation combined with fenestration technique may be safe and feasible for TAD patients with ILVA and unfavorable PLZ.

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