OBJECTIVETo report the initial clinical experience of endovascular thoracic branched stent grafts in the treatment of aortic arch dissections involving the left subclavian artery.

METHODSFrom February 2004 to June 2004, 14 patients were cured with the endovascular thoracic branched aortic stent-grafts made by Beijing YuHengJia SciTech Co. All patients had Stanford type B aortic dissection with the entry tears just beyond the origin of the left subclavian artery by an average distance of 8.7 mm. The branched stents were consisted of the aortic section and the branched section. The diameter of the stents was 15% to 20% larger than the diameter of the landing zones of native arteries. The repair procedure was performed in angiography laboratory. The branched stent grafts were delivered under fluoroscopic guidance and implanted into the aortic arch including the left subclavian artery.

RESULTSFourteen branched stent-grafts and 2 additional flexible stent-grafts were delivered successfully in all 14 cases. The entry tears were excluded completely, and the truth lumen of the dissection was revealed to the normal diameter in all patients. Neither peripheral complication nor death occurred. All 14 patients had recover the normal life.

CONCLUSIONIt demonstrates that it is possible to apply the technical feasibility of endovascular thoracic branched aortic stent graft to repair the intimal tear of dissection just beyond the left subclavian artery.