Endovascular Repair of Aortic Dissection Involving the Left Subclavian Artery by Castor Stent Graft: A Multicentre Prospective Trial

The left subclavian artery (LSA) origin can be intentionally covered by stent grafts, to provide adequate proximal landing zones during thoracic endovascular repair for Stanford type B aortic dissections (TBADs). To preserve the LSA, a novel single branched graft, named “Castor” was designed and clinical trial conducted investigate its suitability. From April 2013 March 2015, 73 patients with TBAD were treated Castor grafts at 11 Chinese tertiary hospitals as part of arm prospective trial. There 50 acute (<2 weeks [68.5%]) 23 chronic (>2 [31.5%]). technical success rate 97% (n = 71/73). two failures caused occlusion branch section graft. four intra-operative endoleaks (two Ia, from LSA). endoleak 5% 4/73). one in hospital death no major complications. median follow up time 61 months (range 48–72 months). mortality 4/73) within year 7% six years 5/73). Two deaths unknown cause three not related aorta. new entry tears found on or distal edge graft retreated endovascularly. Six occlusions found, patency 93% 63/68). eventually disappeared according latest computed tomography angiograms. For TBADs needing anchoring may an easily manipulated, safe, effective treatment.