microport® endovascular attended lijiang vascular surgery intervention treatment summit2018-云顶国际

guilin, china – from may 4 to may 6, microport endovascular (shanghai) co., ltd. ("microport® endovascular") attended the second guangxi guilin lijiang vascular surgery intervention treatment summit and hosted a satellite meeting. the summit focused on the latest development and hot issues of vascular surgery by expert lectures, keynote speeches, as well as debates and discussions.

on may 5, microport® endovascular hosted a satellite meeting on the clinical application of castor® branched aortic stent-graft system ("castor®"). professor xianlan zhang of affiliated hospital of guilin medical university, professor peiyong hou of liuzhou worker's hospital, professor hongwei huang of guilin people's hospital, professor yugui sun of the second affiliated hospital of guilin medical university, and professor hong huang of the second nanning people's hospital were invited to deliver speeches in the satellite meeting.

professor peiyong hou delivered a speech on endovascular reconstruction of aortic arch branches, in which he compared different techniques in reconstruction of aortic arch branches. he pointed out, the reconstruction of lest subclavian artery ("lsa") in tevar has attracted wide attention in the industry. currently, there are four kinds of techniques - hybrid surgery, fenestration operation, chimney stent implantation, branched stent graft. physicians will choose the most suitable technique based on the disease and patient conditions. theoretically, branched stent graft does not change the original structure and conforms to the anatomy of aorta, which is the best choice for the endovascular reconstruction of lsa. in the future, it can be used with other techniques to treat the aortic dissection retrograded to lsa or even innominate artery.

professor xianlan zhang introduced the tactics to use castor® based on clinical cases, and he emphasized on several key steps: when relieving winding wire, the operator should judge the condition at lsa and rotate the system at descending aorta. pushing the system to the arch after adjusting the "8" marker at inner curvature side in the descending aorta；when aligning the branch stent, rotate the "8" marker in the descending aorta to the left side of the patient until it is in the same orientation as it is in the arch; when deploying the main-body stent, the operator should pull the wire-controlled mechanism quickly.

professor hongwei huang shared the indications of castor®. he said, castor® branched aortic stent-graft system is suitable for the aortic dissection with the proximal tear within the area 15mm distal to lcca and 20mm distal to lsa, as well as the dissection retrograded to lsa. the proximal anchor zone should be at least 15mm. with unique unibody design, castor® eliminate the risks of endoleak and perform well in long-term anti-fatigue; the 5-30mm extended loading length from the branch to the proximal end of the mainbody and multi-dimensional rotation can meet different branch orientation; proximal multi-mini spring improves proximal sealing effect. different tapered design is more suitable for patients with aortic dissection in china.

professor yugui sun released the clinical data of castor® which gained the approval from china food and drug administration on june 25, 2017. its pre-market clinical data show: the mortality rate in the hospital is 0%; the related mortality of the aortic dissection in 12 months is 0%; the incidence complication of the stent-related nervous system is 0%; and the incidence of neurological diseases is 5.48%. the clinical effect is being further verified by post market implantation. the hospital recently used castor® to treat a patient with ulcer aortic arch. the postoperative imaging showed that the stent was positioned accurately with good shape.

professor hong huang analyzed a case of castor®. the male patient, 51, was diagnosed as aortic dissection. the distance between lcca and lsa was 11mm. the experts chose castor® to reconstruct the lsa. castor® can expand the proximal anchor zone to healthy area proximal to lsa and reduce the risk of retrograde dissection; the unibody design can realize the double anchoring of the stent graft to both of aorta and the lsa, avoiding the risk of stent graft's slipping into the false lumen and lowering the risk of long-term migration. postoperative image showed that the position of stent was accurate with no migration. the proximal multi-mini spring ensured proximal sealing effect with no endoleak. lsa and lcca flow were unobstructed and the first tear was completely isolated; the true lumen performed well in postoperative images.

in the meeting, li li, vice president of marketing and corporate planning of microport® endovascular, shared the preoperative assessment and product features of castor®. during preoperative assessment, it is necessary to measure the angle and size accurately to ensure that the center line of lsa is parallel to the screen in radiography (use software to find the best expansion angle). the next step is to measure the distance between lcca and lsa, the proximal and distal diameter of aorta and lsa, the length of anchoring zone and the diameter of entry path. afterwards, the physician should take all of the results into consideration and judge the specification of castor®. during the operation, the physician should operate according to the standard procedures.

castor® is the first endovascular device used to preserve the branch artery while repairing the thoracic aorta. its unique "unibody design" could accommodate diverse arch anatomy. the launch of castor® marks a significant step forward in using endovascular repair to treat aortic arch. in the future, microport® endovascular will continue to innovate to develop more leading innovative products and further cultivate the market of aortic interventional treatment, so as to offer cost-effective medical solutions to save or reshape lives or improve the quality of life for patients.