New aortic repair device shows promise in early Scandinavian trial
A branched stent graft designed to treat complex aortic disease while preserving blood flow to critical vessels has been successfully deployed in 23 Scandinavian patients. The early results suggest the technology could expand treatment options for life-threatening aortic conditions that previously required riskier surgery, potentially reducing complications and hospital costs.
Originaltitel: Initial experience and results of a single-branched TEVAR system in Scandinavia
<p>Background: Thoracic endovascular aortic repair (TEVAR) often requires landing in zone 1 or 2 thereby compromising flow through the supra-aortic branch vessels. The Castor (Microport Medical, Shanghai, China) single branched TEVAR system has an incorporated side branch allowing treatment of pathologies reaching zone 2 and 3, whilst preserving flow to aortic arch side branches. This study aims to report on the initial experience and short-term results of all Castor cases done in Scandinavia. Methods: All patients treated with a Castor stent graft in Scandinavia were included in this study. Pre-and postoperative radiologic imaging were examined. Medical journals were investigated. Operative data, technical success, survival, major adverse events and reinterventions were recorded and analyzed retrospectively. Results: Twenty-three patients received a Castor in four different Scandinavian hospitals and were included in this study. Treated pathology included type B dissection (N.=10), penetrating aortic ulcer (N.=3), degenerative aortic aneurysm (N.=7), infective native aortic aneurysm (N.=1), Lusorian aneurysm (N.=1) and a proximal stent graft induced new entry after a previous TEVAR (N.=1). The Castor was deployed in zone 2 with side branch placement in the left subclavian artery (N.=16) or zone 1 with side branch placement in the left common carotid artery (N.=7). Technical success was achieved in 96% (N.=22). Median follow-up was 359 (147-664) days with a side branch patency of 95%. No major adverse events occurred within 30 days. Two reinterventions were performed during follow-up due to a distal stent graft induced new entry. One patient died from myocardial infarction 92 days after the Castor procedure. Conclusions: This multicenter retrospective study represents largest contemporary European series. Short-term results and initial experience were good with no peri-operative strokes, spinal cord ischemia or death reported.</p>