Authors: Hu Jia

Affiliation: West China Hospital, Sichuan University

Introduction to Aortic Arch Conditions

The aortic arch presents numerous anatomical variations and a complex hemodynamic environment, making personalized surgical approaches necessary for treating its diseases.

Treatment Strategies

· Open Surgery: Traditional method requiring thoracotomy.

· Hybrid Technique: Combines elements of open and endovascular procedures to reduce invasiveness.

· Endovascular Repair: Involves the use of stents to repair the aorta internally without opening the chest.

Innovative Stent Applications

· Fontus Single-Branch Stent: Used in open surgery, reduces the time required for extracorporeal circulation and/or deep hypothermic circulatory arrest.

· PerMed Dual-Branch Stent: Shortens the procedure time in complex surgeries involving multiple aortic branches.

Case Studies

· Case 1: A 42-year-old male with a history of hypertension and previous aortic endovascular repair, underwent successful revision with the Fontus stent to address new dissections affecting the aortic arch and left subclavian artery.

· Case 2: A 50-year-old male, a smoker with unmonitored hypertension, presented with acute chest pain and was treated using the PerMed dual-branch stent for an acute Type A dissection.

Results

· Technical Success: 100% immediate technical success rate with minimal complications.

· Follow-Up: Six-month follow-up showed satisfactory results with no major endoleak or need for further interventions.

· Clinical Trial Data: A multicenter randomized controlled trial is underway, with 212 cases enrolled, aiming to evaluate the long-term effectiveness and safety of these new stent systems.

Future Directions

The ongoing development of more sophisticated and minimally invasive stent systems promises to improve outcomes for patients with complex aortic arch diseases.

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