Related Experiment Video
Updated: Dec 31, 2025
Novel and Innovative Hybrid Technique for Type A Aortic Dissection
Published on: March 28, 2025
Branch stent-grafting for endovascular repair of chronic aortic arch dissection
Lei Zhang1, Qingsheng Lu1, Hongqiao Zhu1
1Department of Vascular Surgery, Changhai Hospital, Navy Medical University, Shanghai, China.
Insights
This study shows that novel branched stent-grafting is a safe and effective treatment for chronic aortic arch dissection. Long-term outcomes demonstrate positive aortic remodeling and a low complication rate, offering a promising alternative therapy.
Area of Science:
- Vascular Surgery
- Cardiovascular Research
- Medical Device Technology
Background:
- Chronic aortic arch dissection presents complex treatment challenges.
- Endovascular repair using novel branched stent-grafts offers a potential solution.
Purpose of the Study:
- To present long-term outcomes of endovascular stent-grafting for aortic arch dissection.
- To evaluate the durability and effectiveness of this novel therapy.
Main Methods:
- 51 patients with aortic dissections involving arch branches underwent endovascular stent-grafting (2009-2014).
- Individualized strategies were used for supra-arch branch artery reconstruction.
- Included Stanford type A, retrograde type A, and Stanford type B dissections.
Main Results:
- Successful exclusion of proximal entry tears with no endoleaks.
- Median follow-up of 92 months showed low complication (0.035%/patient-year) and mortality rates (0.020%/patient-year).
- Positive aortic remodeling (true lumen recovery, false lumen shrinkage) observed; 90.1% cervical bypass patency.
Conclusions:
- Endovascular repair with branched stent-grafts is safe and effective for chronic aortic arch dissection.
- Offers a promising alternative with acceptable complication and mortality rates.
- Preoperative planning is crucial for successful outcomes and positive aortic remodeling.
Background:
The preliminary clinical outcomes of a novel branch stent-grafting for endovascular repair of chronic aortic arch dissection proved its safety and effectiveness.
Objective:
The purpose of this study is to present the long-term outcomes and evaluate the durability of this novel endovascular therapy.
Methods:
Between 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.
Results:
All 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.
Conclusions:
Based 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.
