Liu Shangdian, Sun Zhengyang, Qin Jinjin, Dong Yifei, Luo Bin
Department of Cardiovascular Surgery, Shenzhen Baoan People's Hospital, Shenzhen, China.
J Thorac Dis. 2025 Jun 30;17(6):3762-3771. doi: 10.21037/jtd-2024-2102. Epub 2025 Jun 10.
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.
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.
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).
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.
急性B型主动脉夹层需要及时有效的治疗。随着近期对新型Castor单分支覆膜支架植入术的比较疗效和安全性评估的关注，本研究探讨了Castor单分支覆膜支架植入术治疗急性B型主动脉夹层的疗效和安全性，旨在为急性B型主动脉夹层患者提供治疗选择。
回顾性分析2020年1月至2021年11月期间73例急性B型主动脉夹层患者的临床资料。患者分为对照组[接受胸主动脉腔内修复术（TEVAR），35例]和Castor单分支覆膜支架植入手术组（38例）。比较两组的基线数据、术后早期恢复指标、术后早期并发症发生率和死亡率、长期预后、长期疗效以及手术前后主动脉直径的变化。
与对照组相比，Castor单分支覆膜支架植入手术组的重症监护病房（ICU）住院时间（P = 0.03）、术后住院时间（P = 0.01）、总住院时间（P = 0.008）和总并发症发生率（P = 0.03）显著缩短。对照组需要二次干预的患者数量（P = 0.01）和支架边缘新内膜撕裂的形成率（P = 0.02）显著更高，而支架在位比例更低（P = 0.01）。在Castor单分支覆膜支架植入手术组中，病情改善的患者数量显著更多（P = 0.046），术后降主动脉直径更长（P < 0.001）。
Castor单分支覆膜支架植入术在术后早期恢复、较低的并发症发生率以及改善长期预后和有效性方面似乎具有优势。
