first post-云顶国际

suzhou, china – the first post-market implantation of castor™ branched aortic stent-graft system ("castor™"), in-house developed by microport endovascular (shanghai) co., ltd. ("microport® endovascular"), was recently successfully completed by director xiaoqiang li of the second affiliated hospital of soochow university. the product gained the regulatory approval from china food and drug administration in june 2017 to officially enter the china market.

the patient is a 72-year-old male who had been suffering from chest pain for two months prior to hospital admission. preoperative cta showed that the tear length was 29mm and lsa was involved by the false lumen. the distance between lsa and tear was 30mm according to evaluation of endosize software. the operation is quite challenging because: firstly, lsa is involved so that proximal landing zone needs to be extended to reduce the risk of retrograde dissection; secondly, due to the giant tear, the stent graft may slide into false lumen during or after deployment, causing main body stent graft migration; thirdly, the sharp angles of the arch is also a big challenge for proximal sealing effect.

with full understanding of such difficulties, director xiaoqiang li chose to use microport® endovascular's castor™ for the treatment. he said: "castor™ extends the proximal landing zone to healthy area near the lsa, reducing the risk of retrograde dissection. the unibody design of castor® can achieve double anchoring of lsa and thoracic aorta, preventing the stent graft from sliding into the false lumen, and reducing the risk of long-term migration."

the operation started with preoperative dsa performed through femoral artery. the angiography showed that the diameter of proximal was 29mm, so director xiaoqiang li chose 34mm and tapered 6mm castor™. then, according to standard operating procedures, he established branch guide wire channel, and afterwards introduced and deployed the castor™ delivery system. when releasing the main body stent graft, the stent graft should be tightly enclosed the greater curve of the arch with fast deployment, so as to avoid sliding into false lumen. intraoperative angiography showed precise positioning, no endoleak, and slightly slow lsa blood flow. in order to ensure the long-term patency, an 8*40 balloon was used for post-dilation, and a 10*40mm bare stent graft was implanted for prevention purpose. postoperative angiography showed that the proximal triple stents provided excellent sealing effect with no type i endoleak, lsa remained patency, and the tear was completely isolated. the operation achieved successful result and director xiaoqiang li spoke highly of castor®'s clinical performance as well.

castor™ is the world's first stent graft specially designed for endovascular treatment of thoracic aorta and great vessels of the arch simultaneously. it is used for the treatment of thoracic aortic dissection. the device is delivered to the lesion by femoral artery, and after deployment, it will form a new blood flow channel to release the pressure to the vessel wall so as to prevent dissection rupture. castor™ extends the indication of the existing products and allows more patients with complex thoracic aortic aneurysm to receive interventional treatment instead of painful open surgery. castor™ adopts the unibody design, which is sewing the main body and branch stent together to make it possible to deploy and release at the same time. this design innovatively accomplishes deployment and positioning of the unibody branched stent graft, achieving low endoleak rate and better branch artery patency, while reducing the operative trauma and improving safety during the procedure. the launch of castor™ marks a significant step forward in using endovascular repair to treat aortic arch, making breakthroughs in a key area clinicians have spent many years to research and explore.