• Lei Zhang, Qingsheng Lu, Hongqiao Zhu, and Zaiping Jing.
• Department of Vascular Surgery, Changhai Hospital, Navy Medical University, Shanghai, China.
• J. Thorac. Cardiovasc. Surg. 2021 Jul 1; 162 (1): 12-22.e1.

BackgroundThe preliminary clinical outcomes of a novel branch stent-grafting for endovascular repair of chronic aortic arch dissection proved its safety and effectiveness.ObjectiveThe purpose of this study is to present the long-term outcomes and evaluate the durability of this novel endovascular therapy.MethodsBetween August 2009 and January 2014, 51 patients with aortic dissections involving arch branches were treated by the endovascular stent-grafting. There were 7 Stanford type A aortic dissections, 22 retrograde type A aortic dissections, and 22 Stanford type B aortic dissections. The supra-arch branch arteries were reconstructed by individualized strategies.ResultsAll the proximal entry tears in arch were successfully excluded, and no type I/III endoleaks occurred. The median follow-up period was 92 months (range, 62-114 months). A total of 7 complications, 4 deaths, and 3 reinterventions occurred. There were 2 deaths from retrograde type A aortic dissections, 1 death from cerebral infarction, and 1 death from malignant tumor. The incidence of complications, reintervention, all-cause mortality, and aorta-related mortality was 0.035%/patient-year, 0.015%/patient-year, 0.020%/patient-year, and 0.010%/patient-year, respectively. The patency rate of cervical bypass was 90.1%. The significant true lumen recovery and false lumen shrinkage were observed at the 4 designated levels of the thoracic aorta according to computed tomography angiography images.ConclusionsBased on preoperatively adequate planning and accurate measurement, endovascular repair of chronic aortic arch dissection using this branched stent-graft showed a low and an acceptable incidence of complications and mortality with positive aortic remodeling, which provided a satisfactory and promising alternative treatment option.Copyright © 2019 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

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