Utilizing physician modified fenestration on the castor branched stent technique for reconstruction of an isolated left vertebral artery on the aortic arch

The study explores a method to protect the isolated left vertebral artery (ILVA) during thoracic endovascular aortic repair (TEVAR). This is achieved using a physician-modified fenestration (PMF) on a single-branched stent, called Castor. The Castor stent with PMF is placed in the aortic arch to maintain blood flow to the ILVA during the TEVAR procedure. This approach aims to prevent complications like posterior cerebral ischemia or spinal cord ischemia. Preliminary findings suggest this technique is practical, safe, and effective for preserving the ILVA during TEVAR under local anesthesia. The study followed patients for an average of 28.5 months.

• 1
  The PMF on Castor branched stent technique achieved a 100% technical success rate in reconstructing the ILVA in all 25 patients.
• 2
  The procedure effectively maintained ILVA patency for all patients during the follow-up period, with a low rate of reintervention for endoleak.
• 3
  No aortic rupture, stroke, or spinal cord injury occurred throughout the follow-up period after discharge, suggesting the safety of the technique.