Quantitative Assessment of Aortic Arch Conformability and Clinical Outcomes Following Thoracic Endovascular Aortic...

Thoracic stent graft conformability is believed to provide mechanical advantages during thoracic endovascular aortic repair (TEVAR); however, quantitative evidence and associated clinical outcomes remain limited. This study aimed to assess stent graft conformability across varying aortic arch configurations and pathologies, and to evaluate short- and mid-term technical and clinical outcomes.

A retrospective, single-centre review was conducted of TEVAR procedures performed using the GORE cTAG stent graft over a seven-year period. Pre- and post-deployment anatomical measurements were obtained using Endosize® software to assess conformability across a range of aortic arch morphologies and aortic syndromes. Conformability was defined as a < 10% change in predefined anatomical parameters, including aortic arch angle and proximal landing zone (PLZ) angle. Demographic data, mortality, complications, incidence of bird beaking, and reintervention rates were analysed.

Of 189 TEVAR procedures performed during the study period, 111 met inclusion criteria and utilised the GORE cTAG stent graft. High conformability was observed following intervention, with 79% of patients demonstrating < 10% change in aortic arch angle and 88% demonstrating < 10% change in PLZ angle. Bird beaking occurred in 10.8% of patients. The overall reintervention rate was 5.4%, with greater angular changes significantly associated with reintervention (p = 0.039). Overall survival rates at 30 days, 1 year, and 5 years were 95%, 86%, and 80%, respectively.

The GORE cTAG stent graft demonstrates high conformability across diverse aortic arch morphologies and pathologies, which is associated with favourable short- and mid-term technical and clinical outcomes.