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Objective <p>To evaluate the feasibility and safety of total arch replacement with a frozen elephant trunk in patients with Stanford type B aortic dissection and an entry ≤ 10&#xa0;mm distal to the left subclavian artery.</p> Methods <p>We retrospectively reviewed 40 consecutive patients who underwent either total arch replacement with a frozen elephant trunk (<i>n</i> = 30) or thoracic endovascular aortic repair (<i>n</i> = 10). The primary outcome was late all-cause mortality. Secondary outcomes included major complications, planned additional endovascular repair after total arch replacement with a frozen elephant trunk, false lumen thrombosis, and aortic remodeling.</p> Results <p>In the thoracic endovascular aortic repair group, procedure-related complications occurred, including retrograde type A dissection and one death from aortic rupture. In the total arch replacement with a frozen elephant trunk group, all deaths were unrelated to the index procedure. Planned additional endovascular repair was more frequently performed after total arch replacement with a frozen elephant trunk.</p> Conclusions <p>Total arch replacement with a frozen elephant trunk is safe for anatomically challenging type B aortic dissection with an entry near the left subclavian artery and represents a viable treatment option in this setting.</p>

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Efficacy of total arch replacement with frozen elephant trunk for type B aortic dissection involving left subclavian artery-adjacent entry: a strategy for anatomically challenging cases

  • 期刊论文

  • 发表日期：

    2025年11月3日

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  • Norimasa Haijima,
  • Mikihiko Kudo,
  • Satoru Murata,
  • Takuya Ono,
  • Hideyuki Shimizu

摘要

Objective

To evaluate the feasibility and safety of total arch replacement with a frozen elephant trunk in patients with Stanford type B aortic dissection and an entry ≤ 10 mm distal to the left subclavian artery.

Methods

We retrospectively reviewed 40 consecutive patients who underwent either total arch replacement with a frozen elephant trunk (n = 30) or thoracic endovascular aortic repair (n = 10). The primary outcome was late all-cause mortality. Secondary outcomes included major complications, planned additional endovascular repair after total arch replacement with a frozen elephant trunk, false lumen thrombosis, and aortic remodeling.

Results

In the thoracic endovascular aortic repair group, procedure-related complications occurred, including retrograde type A dissection and one death from aortic rupture. In the total arch replacement with a frozen elephant trunk group, all deaths were unrelated to the index procedure. Planned additional endovascular repair was more frequently performed after total arch replacement with a frozen elephant trunk.

Conclusions

Total arch replacement with a frozen elephant trunk is safe for anatomically challenging type B aortic dissection with an entry near the left subclavian artery and represents a viable treatment option in this setting.