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| Comparison of Clinical Efficacy between Extracorporeal Aortic Stent Fenestration and Castor Branch Covered Stent TEVAR for LSA Reconstruction in Treatment of Aortic Arch Lesions |
| LI Xiaoheng, LI Yanping, FU Xiaoke, et al |
| Luoyang Central Hospital, Luoyang Henan 471000 |
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Abstract 【Objective】To compare the clinical efficacy of extracorporeal aortic stent fenestration and Castor branch covered stent for thoracic endovascular aortic repair(TEVAR) reconstructing the left subclavian artery(LSA) in the treatment of aortic arch lesions. 【Methods】A total of 71 patients with aortic arch lesions admitted to our hospital from January 2020 to January 2023 were selected and divided into an extracorporeal window group(aortic stent extracorporeal window opening, n=51) and an extracorporeal branch group(Castor branch covered stent TEVAR reconstruction LSA, n=21) based on different LSA reconstruction methods. The perioperative indicators, surgical success rate, and postoperative complication incidence of the two groups of patients were compared; The follow-up prognosis after 1 year showed the remodeling of the sandwich cavity and the patient's false lumen thrombosis after the dissection surgery. 【Results】The surgical time, success rate of instrument release, and surgical cost of the external branch group were all higher than those of the external window group(P<0.05). The change rate of true lumen area [R(ATL)] in the L1, L3, and L4 stent segments and the external branch group was higher than that in the external fenestration group(P<0.05); The false lumen area change rate [R(AFL)] and true lumen diameter change rate [R(DTL)] in the L3 external branch group of the stent segment were higher than those in the in vitro fenestration group, while the L4 R(DTL) was higher than those in the in vitro fenestration group(P<0.05). There was no statistically significant difference in the degree of false lumen thrombosis between the two groups of patients in the stent and non stent segments(P>0.05). 【Conclusion】Both extracorporeal stent fenestration and Castor branch coated stent TEVAR for LSA reconstruction in treatment of aortic arch lesions have good safety and effectiveness. Castor branch coated stent TEVAR has a shorter operating time and better proximal stent remodeling effect than extracorporeal fenestration TEVAR.
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Received: 25 February 2024
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2024, Vol. 41 
