Endovascular Repair of Non-A Non-B Aortic Dissection Using a Concave Supra-Arch Triple-Branched Stent-Graft.

Abstract

<h4>Background</h4>Non-A non-B aortic dissection remains a complex and controversial pathology. Although open repair remains the gold standard, its invasiveness may limit applicability in high-risk patients.<h4>Case summary</h4>We present the case of a 65-year-old woman with non-A non-B dissection and prohibitive surgical risk who underwent successful total endovascular arch repair using a Concave Supra-arch triple-branched stent-graft (CS) system (Lifetech Scientific). The procedure involved precise deployment of the main body, selective catheterization, and bridging stent placement. Follow-up imaging confirmed entry tear exclusion, branch patency, and favorable remodeling without complications.<h4>Discussion</h4>The CS device features a concave configuration along the greater curvature, with 2 antegrade branches for the innominate and left common carotid arteries and 1 retrograde branch for the left subclavian artery, facilitating stable anatomic reconstruction.<h4>Take-home messages</h4>Total endovascular arch repair with the CS system offers a viable solution for high-risk patients. Routine application warrants caution owing to limited outcomes data.