Enhancing Castor stent graft placement: A novel approach using direction-turnover and unwrapping techniques

Area of Science:

• Vascular Surgery
• Endovascular Interventions
• Medical Device Technology

Background:

• Aortic arch lesions involving the left subclavian artery (LSA) often necessitate endovascular repair.
• The Castor single-branch stent graft offers a specialized solution for these complex anatomical challenges.
• Direction-turnover and unwrapping techniques may further optimize the use of the Castor graft.

Purpose of the Study:

• To assess the safety and efficacy of combining direction-turnover and unwrapping techniques with the Castor stent graft.
• To evaluate short-term clinical outcomes in patients undergoing this combined approach for aortic arch and LSA lesions.

Main Methods:

• A prospective study included 18 patients with aortic arch and LSA lesions treated with the Castor stent graft.
• Procedures were performed between January 2022 and June 2023 at Binzhou Medical University Hospital.
• Computed tomography angiography (CTA) was utilized for pre- and post-operative assessment at multiple time points.

Main Results:

• Successful stent graft placement was achieved in all 18 patients.
• No intraoperative complications, stent migration, or residual shunting were observed.
• Postoperative CTA confirmed accurate placement, with no thrombosis or endoleaks detected.

Conclusions:

• The direction-turnover and unwrapping techniques enhance the precision and safety of Castor stent graft deployment.
• These methods effectively mitigate guidewire entanglement, leading to improved procedural success rates.
• The combined approach demonstrates significant potential for wider application in complex aortic arch interventions.