The following is a summary of “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,” published in the February 2024 issue of Cardiology by Zheng et al.

Researchers started a retrospective study to compare the effectiveness of 3D printing-assisted extracorporeal pre-fenestration, and Castor integrated branch stent techniques for treating Stanford type B aortic dissections (TBAD) with inadequate proximal landing zones.

They analyzed 84 TBAD patients who received thoracic endovascular aortic repair (TEVAR) with LSA reconstruction (January 2022 – July 2023). Two groups were formed based on surgical techniques: 3D printing-assisted pre-fenestration (44 patients) and Castor integrated branch stent (40 patients). Clinical indicators like patient details, operative time, success rates, complication rates, re-intervention rates, mortality, and aortic remodeling were compared to assess the post-TEVAR mortality rate.

The results showed 100% surgical and device deployment success rates in both groups, with no significant difference (P>0.05). However, the 3D printing group had longer operative times (184.20 ± 54.857 min) compared to the Castor stent group (152.75 ± 33.068 min), with a significant difference (t = 3.215, P=0.002, P<0.05). The incidence of postoperative cerebral infarction and beak sign was lower in the 3D printing group, showing statistical significance. Other complication rates and aortic remodeling didn’t differ significantly (P>0.05). CT angiography revealed vascular lumen expansion and false lumen reduction in both groups. Follow-up duration was similar (10.59 ± 4.52 vs 9.08 ± 4.35 months, t = 1.561, P=0.122 > 0.05). No new endoleaks, spinal cord injuries, or limb ischemia occurred during follow-up. One patient in the Castor group had a further distal dissection. One mortality happened in each group due to COVID-19. Re-intervention and survival rates didn’t differ significantly (P>0.05).

Investigators concluded that both techniques were successful, though 3D printing led to fewer strokes while the castor method was faster.

Source: bmccardiovascdisord.biomedcentral.com/articles/10.1186/s12872-024-03799-x