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Implantation of Unibody Single-Branched Stent Graft for Patients with Type B Aortic Dissections Involving the Left Subclavian Artery: 1-Year Follow-Up Outcomes

  • Clinical Investigation
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Abstract

Objective

To report the early results of castor device, a kind of unibody single-branched stent graft, in the treatment of type B aortic dissection (TBAD) involving the LSA.

Methods

From April 2013 to February 2014, 21 patients with TBADs underwent TEVAR with LSA revascularization by unibody single-branched stent grafts. Three patients with penetrating aortic ulcers in the aortic arch received additional reconstruction of left common carotid artery with chimney technique. Follow-up evaluations were conducted with computed tomography angiography (CTA) at 6, 12 months and annually after that.

Results

All of the proximal entry tears were completely excluded. Good patency of the grafts was found in all cases. A small type I endoleak occurred in one patient during the procedure. Perioperative mortality is null, and there was no occurrence of serious complications. All patients completed the follow-up except one lost contact after discharge. One death occurred within 6 months after the operation, resulting from myocardial infarction, considered unrelated to the stent implantation. No endoleak occurred during follow-up. One compression of a chimney stent and one twist of side branch graft of castor were observed in 2 different patients, respectively. In other cases, CTA scans showed good patency of both the branched and chimney grafts. Two patients had partial thrombosis of the false lumen during follow-up. In other patients, complete thrombosis in the false lumen in thoracic aorta was revealed.

Conclusion

The single-branched stent graft was safe and efficient in the 1-year follow-up. Further studies are required to determine its long-term outcomes.

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Acknowledgements

There are no acknowledgements and there was no specific research or project funding for this research.

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Author notes

  1. He Huang and Yuanyong Jiao have contributed equally to this work and should be considered co-first authors.

Authors and Affiliations

  1. Department of Vascular Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, People’s Republic of China

    He Huang, Yepeng Zhang, Yuelin Zhu, Zhao Liu, Tong Qiao, Changjian Liu & Min Zhou

  2. Department of Vascular Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, People’s Republic of China

    Yuanyong Jiao & Xiwei Zhang

Authors
  1. He Huang
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  2. Yuanyong Jiao
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  3. Yepeng Zhang
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  4. Yuelin Zhu
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  5. Zhao Liu
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  6. Tong Qiao
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  7. Changjian Liu
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  8. Xiwei Zhang
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  9. Min Zhou
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Corresponding authors

Correspondence to Xiwei Zhang or Min Zhou.

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The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Assigned informed consent was obtained from all patients.

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Huang, H., Jiao, Y., Zhang, Y. et al. Implantation of Unibody Single-Branched Stent Graft for Patients with Type B Aortic Dissections Involving the Left Subclavian Artery: 1-Year Follow-Up Outcomes. Cardiovasc Intervent Radiol 40, 1678–1686 (2017). https://doi.org/10.1007/s00270-017-1748-4

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  • DOI: https://doi.org/10.1007/s00270-017-1748-4

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