The efficacy and safety of castor single-branch stent graft implantation in the treatment of type B acute aortic dissection: a retrospective analysis

Castor单分支支架移植术治疗B型急性主动脉夹层的疗效和安全性:一项回顾性分析

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Abstract

BACKGROUND: Acute type B aortic dissection requires timely and effective treatment. With recent focus on evaluating the comparative efficacy and safety of novel Castor single-branch covered-stent implantation, this study investigated the efficacy and safety of Castor single-branch covered-stent implantation in the treatment of acute type B aortic dissection, aiming to provide treatment option for patients with acute type B aortic dissection. METHODS: Clinical data of 73 patients with acute type B aortic dissection (January 2020 to November 2021) were retrospectively analyzed. Patients were divided into control [undergoing thoracic endovascular aortic repair (TEVAR), 35 cases] and Castor single-branch covered-stent implantation surgery (38 cases) groups. Baseline data, early postoperative recovery indicators, incidence of early postoperative complications and mortality, long-term prognosis, long-term efficacy, and changes in aortic diameter before and after surgery were compared. RESULTS: Castor single-branch covered-stent implantation surgery group had significantly shorter intensive care unit (ICU) stay (P=0.03), postoperative hospital stay (P=0.01), total hospital stay (P=0.008), total complication rate (P=0.03) compared to the control group. The number of patients requiring secondary intervention (P=0.01) and formation of new intimal tears at the stent edges (P=0.02) was significantly higher in the control group, whereas proportion of stents in position was lower (P=0.01). In the Castor single-branch covered-stent implantation surgery group, number of patients whose condition improved was significantly higher (P=0.046), and the descending aortic diameter postoperatively was longer (P<0.001). CONCLUSIONS: Castor single-branch stent graft implantation appears to offer advantages in terms of early postoperative recovery, lower complication rates, and improved long-term prognosis and effectiveness.

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