Clinical comparative analysis of 3D printing‑assisted extracorporeal pre‑fenestration and Castor integrated branch stent techniques in treating type B aortic dissections with inadequate proximal landing zones

BMC Cardiovascular Disorders, 2024 · DOI: https://doi.org/10.1186/s12872-024-03799-x · Published: March 1, 2024

Simple Explanation

This study compares two surgical techniques for treating type B aortic dissections (TBAD) when there isn't enough healthy aorta for the stent to grab onto: 3D printing-assisted extracorporeal pre-fenestration and Castor integrated branch stent techniques. The 3D printing technique involves creating a model of the patient's aorta to help create a hole (fenestration) in the stent before it is implanted. The Castor technique uses a stent with a built-in branch to connect to the left subclavian artery. The study found that both techniques are effective, but the 3D printing method had a lower risk of certain complications, while the Castor method was faster.

Study Duration

January 2022 to July 2023

Participants

84 patients with type B aortic dissection

Evidence Level

Not specified

Key Findings

1
The surgical success rate and device deployment success rate were 100% in both groups.
2
The 3D printing group had a significantly longer operative time compared to the Castor stent group.
3
The incidence of postoperative cerebral infarction and beak sign was significantly lower in the 3D printing group.

Research Summary

This study compared 3D printing-assisted extracorporeal pre-fenestration TEVAR and castor-integrated branch stent techniques for treating Stanford type B aortic dissection with inadequate proximal anchoring. Both techniques demonstrated good safety and efficacy. The 3D printing-assisted technique had a lower incidence of postoperative cerebral infarction and beak sign, while the castor-integrated branch stent technique had advantages in operative time.

Practical Implications

Technique selection

For TBAD patients with complex aortic arch anatomy, 3D-printing-assisted TEVAR may be preferred. For those with simpler anatomy or needing urgent surgery, the Castor stent may be better.

Reduced Complications

The 3D-printing-assisted extracorporeal pre-fenestration TEVAR technique exhibits a lower postoperative incidence of cavity-type cerebral infarctions and “bird-beak” signs.

Shorter Operative Times

The Castor integrated branch stent technique offers an advantage in terms of shorter operative times.

Study Limitations

1
The materials used in 3D-printed aortic models are relatively rigid.
2
The current stent models may not meet the needs of all cases due to individual anatomical variations.
3
Small sample size and a short follow-up period.

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