recently, endovastec™'s hector™ multi-branch thoracic aortic stent-graft system (hector™) completed its first clinical application in switzerland.
the implantation was conducted by professor alexander zimmermann and his team at university hospital zurich. the female patient had previously undergone surgery for ascending aortic graft replacement and had a straight stent graft in the descending aorta. during a follow-up, a significant pseudoaneurysm measuring approximately 33.6mm was detected at the distal anastomosis of the artificial blood vessel, posing a risk of rupture and potential life-threatening consequences. given the patient's high surgical risk and the lesion's proximity to the junction of the ascending aorta and brachiocephalic artery, an endovascular treatment using existing aortic stents was deemed impractical. additionally, due to the challenging position of the lesion, the use of chimney or fenestrated stents was highly likely to cause endoleaks. after a comprehensive clinical assessment, professor zimmermann proposed using the hector™ to address the patient's condition.
the case presented two challenges: 1.) the patient's large aortic defect being located on the small curvature of the ascending aorta, which offered only a 2cm landing zone; and 2.) the patient’s type iii arch, making left subclavian artery (lsa) reconstruction particularly challenging. the hector™’s unique features, including its tip capture design and branch wire traction positioning, ensured precise stent placement. this design effectively sealed the large defect at the anastomosis. additionally, the hector™'s preloaded catheter simplified the process of lsa cannulation. the surgical procedure proceeded smoothly, with the hector™ implantation proving relatively simple compared to other endovascular treatments for aortic arch lesions, leading to reduced operative durations. postoperative imaging revealed patent blood flow in all branch vessels, effective exclusion of the pseudoaneurysm, and no endoleaks or stent displacement, indicating a successful procedure. the patient has since been discharged from the hospital.
professor zimmermann remarked: "the hector™'s integrated branch stent design requires only unilateral incision of the carotid artery for three-branch reconstruction, while the preloaded catheter makes lsa cannulation remarkably convenient. the semi-deployment design in the sinking area ensures easy left common carotid artery (lcca) channel selection, simplifying the entire procedure and reducing operation time, with potential to decrease the occurrence of cerebral infarction in such surgeries."
endovascular treatment of aortic arch lesions remains a significant challenge in the medical field, with no commercially available products for full three-branch reconstruction of the aortic arch to date. following the pioneering success of the castor™ branched aortic stent-graft and delivery system (castor™) in addressing single-branch reconstruction challenges, hector™ is now poised to tackle more complex three-branch reconstruction issues.
the successful implantation of the hector™ highlights endovastec™’s pioneering approach in the global clinical application of products under development, fostering deeper collaboration with clinical experts worldwide. looking ahead, endovastec™ is committed to advancing comprehensive medical solutions for aortic and peripheral vascular diseases, bringing more high-quality, innovative products to the global markets.
about hector™
the hector™, developed based on castor™, facilitates intraluminal reconstruction of the aortic arch's three branches. it inherits the integrated branch structure design unique to castor™, with a single branch utilized for the reconstructing the brachiocephalic artery, lcca, and left subclavian artery. the hector™ incorporates several patented technologies, including the pre-positioned lsa cannula and semi-deployment in the sinking area, ensuring efficient surgical procedures. the castor™, used for endovascular treatment of aortic arch dissection, is the first approved branched aortic stent-graft for the market worldwide. since its launch in 2017, it has been approved in 15 countries, with over 20,000 implants.