This study states that Single-branched thoracic endografts (SBTEs) are under investigation for treatment of thoracic aortic disease that requires zone 2 seal during thoracic endovascular aortic repair (TEVAR). A variety of anatomic criteria must be met for their effective implantation. Our aim was to analyze anatomic suitability for SBTE. We performed a retrospective review of 103 TEVAR procedures in 88 patients at our academic referral center between 2017 and 2019. Proximal seal was achieved in zone 3 or zone 4 (n = 37 [36%]), zone 2 (n = 30 [29%]), or zone 0 or zone 1 (n = 36 [35%]). We analyzed the zone 2 group’s operative angiograms and preoperative computed tomography angiograms using centerline software to measure arterial diameters and length in relation to the left common carotid artery, left subclavian artery (LSA), and proximal extent of aortic disease to determine whether patients met anatomic criteria using the instructions for use. Approximately half of patients who require TEVAR seal in zone 2 meet criteria for this SBTE. The device may offer the ability to provide flow to the LSA without the need for adjuvant revascularization procedures. Patients with aneurysms more often met the IFU than those with acute dissection. A modification to the IFU to allow dissection up to the LSA origin would increase eligibility in ATBD by >50%. Clinical efficacy data, however, are needed to determine whether this would be effective.

Reference link-