{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T18:42:24Z","timestamp":1792089744851,"version":"4.4.0"},"reference-count":27,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,11,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Repair of aortic arch aneurysms is challenging whether by open surgery or endovascular techniques. The aim of this study was to analyse the midterm outcomes of an innovative endovascular thoracic aortic stent-graft with a triple branch design (Cook Medical, Bloomington, IN, USA) and to compare the outcomes in patients with a retrograde or an antegrade branch for the left common carotid artery (LCCA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>All patients treated with the custom-made triple-branch arch device between October 2018 and April 2025 at a single tertiary-care hospital were enrolled. Demographics, co-morbidities, indication for the procedure, procedural details, and outcomes were recorded. The primary aim was to evaluate midterm clinical outcomes, including branch primary patency and reintervention rates. The secondary aim was to compare outcomes based on LCCA branch orientation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Some patients were treated. Indications were degenerative (49%) or post-dissection (51%) arch aneurysms. Percutaneous approach was more common in the retrograde group (74% versus 24%, P &amp;lt; 0.001), which also had shorter operative times (160.5 versus 234.0\u2005min, P &amp;lt; 0.001). Thirty-day stroke occurred in five patients (7%; 3% retrograde versus 11% antegrade, P = 0.361). Thirty-day mortality was 3% (3% versus 3%, P = 1) and postoperative heart failure developed in three patients (6% versus 3%, P = 0.599). Median follow-up was 35.8 months (i.q.r. 17.5\u201362.6 months). During follow-up, 8 patients died (11%) and 14 (19%) required reintervention. Branch primary patency was 100%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Endovascular aortic arch repair with a triple-branch device is associated with favourable early outcomes. A retrograde LCCA branch orientation was associated with shorter operative times, and an increased potential for a totally percutaneous approach. Multicentre studies are required to confirm these findings and evaluate long-term outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/bjs\/znaf227","type":"journal-article","created":{"date-parts":[[2025,11,9]],"date-time":"2025-11-09T07:23:47Z","timestamp":1762673027000},"source":"Crossref","is-referenced-by-count":13,"title":["Endovascular aortic arch repair with a triple branch arch device"],"prefix":"10.1093","volume":"112","author":[{"given":"Emanuele C","family":"Grasso","sequence":"first","affiliation":[{"name":"Department of Cardiac and Vascular Surgery, Aortic Center, H\u00f4pital Marie Lannelongue, Groupe Hospitalier Paris Saint Joseph, INSERM UMR_S 999, Universit\u00e9 Paris-Saclay , Paris ,","place":["France"]},{"name":"Department of Vascular and Endovascular Surgery, ASST Fatebenefratelli Sacco , Milano ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8969-6037","authenticated-orcid":false,"given":"Roberto G","family":"Aru","sequence":"additional","affiliation":[{"name":"Department of Cardiac and Vascular Surgery, Aortic Center, H\u00f4pital Marie Lannelongue, Groupe Hospitalier Paris Saint Joseph, INSERM UMR_S 999, Universit\u00e9 Paris-Saclay , Paris ,","place":["France"]},{"name":"Division of Vascular and Endovascular Surgery, Department of Surgery, Thomas Jefferson University Sidney Kimmel Medical College , Philadelphia, Pennsylvania ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federico F","family":"Pennetta","sequence":"additional","affiliation":[{"name":"Department of Cardiac and Vascular Surgery, Aortic Center, H\u00f4pital Marie Lannelongue, Groupe Hospitalier Paris Saint Joseph, INSERM UMR_S 999, Universit\u00e9 Paris-Saclay , Paris ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Le Hou\u00e9rou","sequence":"additional","affiliation":[{"name":"Department of Cardiac and Vascular Surgery, Aortic Center, H\u00f4pital Marie Lannelongue, Groupe Hospitalier Paris Saint Joseph, INSERM UMR_S 999, Universit\u00e9 Paris-Saclay , Paris ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominique","family":"Fabre","sequence":"additional","affiliation":[{"name":"Department of Cardiac and Vascular Surgery, Aortic Center, H\u00f4pital Marie Lannelongue, Groupe Hospitalier Paris Saint Joseph, INSERM UMR_S 999, Universit\u00e9 Paris-Saclay , Paris ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"St\u00e9phan","family":"Haulon","sequence":"additional","affiliation":[{"name":"Department of Cardiac and Vascular Surgery, Aortic Center, H\u00f4pital Marie Lannelongue, Groupe Hospitalier Paris Saint Joseph, INSERM UMR_S 999, Universit\u00e9 Paris-Saclay , Paris ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,11,6]]},"reference":[{"key":"2025110902234313700_znaf227-B1","doi-asserted-by":"crossref","first-page":"838","DOI":"10.1016\/j.jtcvs.2011.09.069","article-title":"Contemporary results of open aortic arch surgery","volume":"144","author":"Thomas","year":"2012","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2025110902234313700_znaf227-B2","first-page":"668","article-title":"Frozen elephant trunk technique for aortic arch surgery: the Bordeaux University Hospital experience with thoraflex hybrid prosthesis","volume":"64","author":"Cuko","year":"2023","journal-title":"J Cardiovasc Surg (Torino)"},{"key":"2025110902234313700_znaf227-B3","doi-asserted-by":"crossref","first-page":"ezae041","DOI":"10.1093\/ejcts\/ezae041","article-title":"Is surgical risk of aortic arch aneurysm repair underestimated? 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