Midterm Results of Prospective Study for Aortic dissection with Gutter-Plugging Chimney Stent-Graft.

BACKGROUND: To access early and midterm outcomes of a gutter-plugging chimney stent-graft for treatment of Stanford type B aortic dissections (TBAD) in the clinical trial of Prospective Study for Aortic Arch Therapy with stENt-graft for Chimney technology (PATENCY).

METHODS: Between October 2018 and March 2022, patients with TBAD were treated with the LonguetteTM chimney stent-graft in 26 vascular centers. The efficiency and the incidence of adverse event over 12 months were investigated.

RESULTS: ：A total of 150 patients were included. The technical success rate was 99.33% (149/150). The incidence of immediate postoperative endoleak was 5.33% (8/150, type I, n = 6; type II, n = 1; type IV, n = 1), neurologic complications (stroke or spinal cord ischemia) and 30-day mortality were 0.67% (1/150) and 1.33% (2/150), respectively. During the follow-up, the median follow-up time was 11.67 (5-16) months. The patent rate of Longuette graft is 97.87%. Two type I endoleak patients underwent reintervention. The follow-up rate of incidence of retrograde A type aortic dissection was 0.67% (1/150). There was no paraplegia, left arm ischemia, or stent migration.

CONCLUSION: For revascularization of the left subclavian artery, the LonguetteTM chimney stent graft can provide an easily manipulated, safe, and effective endovascular treatment. It should be considered a more efficient technique to prevent type Ia endoleak. Longer follow-up and a larger cohort are needed to validate these results.