Endovascular repair of descending aorta lesions using a second-generation unibody single-branched stent-graft: a technical note.

Abstract

Background: This report describes the second-generation unibody Cratos single-branched stent-graft for left subclavian artery (LSA) revascularization during thoracic endovascular aortic repair (TEVAR).

Methods: The Cratos device represents the second-generation evolution of the Castor single-branched stent-graft, featuring an outer unibody branch configuration that allows simultaneous exclusion of the primary entry tear and revascularization of the LSA. It incorporates an adjustable proximal stent segment that optimizes sealing and reduces the risk of bird-beak formation at the proximal landing zone, while a reinforced branch-main body junction enhances fatigue resistance and long-term durability.

Results: We reported 2 patients presented with TBAD extending to the distal aortic arch, with the primary entry tear located just distal to the LSA zone 3. Both were successfully treated with the Cratos single-branched stent-graft, achieving complete exclusion of the entry tear and preservation of LSA flow without endoleak or neurological complications during follow-up.

Conclusions: The Cratos single-branched stent-graft provides a safe and effective option for one-stage endovascular repair of aortic arch pathologies requiring zone 2 landing. Long-term follow-up and larger studies are warranted to confirm these promising early outcomes.