Initial Multicenter Experience With the New Castor Arch Branched Device in Europe: A Middle-term Results Study

Area of Science:

• Vascular Surgery
• Endovascular Aortic Repair
• Aortic Pathologies

Background:

• The Castor stent-graft is a promising treatment for aortic pathologies requiring landing zone 2.
• Limited data exists on the medium-term outcomes of the Castor device in European populations.
• This study addresses the need for more information on Castor stent-graft efficacy and safety.

Purpose of the Study:

• To evaluate the mid-term results of the Castor stent-graft in Polish patients.
• To assess the safety and efficacy of the Castor device for various aortic pathologies.
• To contribute to the understanding of Castor stent-graft performance in a European cohort.

Main Methods:

• Retrospective analysis of 21 patients from 5 Polish vascular surgery centers.
• Inclusion criteria: type B aortic dissection, thoracic aortic aneurysms, intramural hematomas, penetrating aortic ulcerations.
• Evaluation of early and long-term complications, reinterventions, and technical success rates.

Main Results:

• High survival rate (95.24%) and technical success (90.48%) with no endoleaks.
• Observed complications included type I endoleaks, bird beak phenomenon, and access site issues.
• Reinterventions were required for type I endoleak and left subclavian artery branch thrombosis; two patients needed subsequent branched endovascular aortic repair.

Conclusions:

• The Castor stent-graft is user-friendly and demonstrates good medium-term outcomes.
• It represents an excellent option for cases needing left subclavian artery revascularization during thoracic endovascular aortic repair.
• Further research is needed to fully elucidate the safety and efficacy of the Castor device.