Mid-term Results of Endovascular Repair for Type B Aortic Dissection: A Device-specific Comparative Analysis.

Abstract

Objectives: To compare the efficacy of the Conformable TAG Thoracic Endoprosthesis (CTAG) and the Valiant Captivia System Stent Graft in thoracic endovascular aortic repair (TEVAR) for type B aortic dissection (TBAD).

Methods: TBAD patients treated from 2016-2022 at a Chinese tertiary center with a CTAG or Captivia stent graft were eligible for inclusion and their data were retrospectively collected and analyzed. Intraoperative characteristics, short-term outcomes during hospitalization, mid-term outcomes during follow-up and aortic remodeling were analyzed and compared between two groups.

Results: In total, the study included 617 patients (372 CTAG and 245 Captivia). The baseline characteristics of both groups were comparable. Procedural details showed that the CTAG group had larger stent diameter (P < 0.001) and higher oversize ratio (P < 0.001) than the Captivia group and led to less intraoperative type I endoleak cases (P = 0.01). Complications during hospitalization, especially stroke, occurred more commonly in the Captivia group (P = 0.033). Mid-term outcomes including readmission rate and aortic-related mortality were comparable between the two groups. And CTAG performed better in aortic remodeling with higher expansion rate of true lumen than Captivia in the stented segment of aorta (P < 0.001).

Conclusions: Both CTAG and Captivia offered comparable and favorable mid-term survival rates and freedom from readmission in patients with TBAD. CTAG performed better during TEVAR operations and in short-term outcomes, including reducing intraoperative type I endoleak and avoiding complications during hospitalization. Additionally, CTAG achieved an improved aortic remodeling effect in expanding the true lumen of aorta.