{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T02:07:54Z","timestamp":1789610874032,"version":"build-2803163510"},"reference-count":28,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,3,15]],"date-time":"2026-03-15T00:00:00Z","timestamp":1773532800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Endovasc Ther"],"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To evaluate the early-term outcomes of endovascular repair for zone 2 aortic arch pathologies using the Castor single-branched stent-graft, with adjunctive chimney technique employed when extending for proximal extension into zones 1 and 0.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      A\n                      <jats:bold>s<\/jats:bold>\n                      ingle-center retrospective study was conducted on 63 patients (mean age=57.0\u00b113.4 years; 55 males, 87.3%) with zone 2 aortic pathologies treated between February 2023 and June 2024. Proximal landing zones determined treatment strategy: Standard zone 2 landing (n=37, Castor branch in left subclavian artery [LSA]); extended zone 1 landing (n=20, Castor branch in LSA+LCCA chimney); extended zone 0 landing (n=6, Castor branch in LCCA+innominate artery (IA) chimney+selective LSA revascularization based on vertebral artery dominance). Baseline characteristics, procedural data, and outcomes were analyzed to assess technical success, perioperative\/follow-up complications, reinterventions, and branch patency. Outcomes were described separately for each landing zone cohort (zones 2, 1, and 0).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The overall technical success was 96.8% (61\/63). No mortality, stroke, paraplegia, retrograde type A aortic dissection\/ (RTAAD), endoleak, or upper limb ischemia occurred within the 30-day postoperative period. During a mean follow-up of 17.4\u00b15.5 months, the overall endoleak rate was 1.6% (1\/63), comprising a single zone 2 landing type II endoleak (LSA backflow) detected at the 3-month follow-up. No graft-related type I\/III endoleaks occurred. Branch occlusion occurred in 1.6% of cases (1\/63), involving the Castor LSA branch in a zone 1 landing case at 10 months. All chimney stent-grafts maintained patency. Reinterventions (3.2%, 2\/63) comprised: one zone 2 landing type II endoleak, and one zone 1 landing complications (LSA occlusion). All-cause mortality was 1.6% (1\/63, occurring at 11 months postoperatively in a zone 1 landing patient due to non-aortic-related causes).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>The Castor single-branched stent-graft enabled effective zone 2 reconstruction. Combined with chimney technique, it facilitated treatment extension into zone 1 and exploratory applications in zone 0. The results for each strategy demonstrate high technical success, a favorable safety profile, high branch\/chimney patency rates, and low-complication rates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Impact<\/jats:title>\n                    <jats:p>This study demonstrates that the Castor single-branched stent-graft is safe and effective in endovascular repair of zone 2 aortic arch pathologies. Combined with a chimney stent, its application can be successfully extended to zone 1 and exploratory zone 0 cases. This hybrid strategy provides a minimally invasive endovascular alternative for complex arch pathologies, particularly in patients at high surgical risk or ineligible for custom-made devices. This work contributes by providing the first detailed perioperative and follow-up data for this combined approach, including preliminary technical experience in highly selected zone 0 reconstructions, thereby enriching the evidence base for endovascular arch repair.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15266028261433405","type":"journal-article","created":{"date-parts":[[2026,3,15]],"date-time":"2026-03-15T23:57:38Z","timestamp":1773619058000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Early Outcomes of Castor Single-Branched Stent-Graft for Zone 2 Aortic Arch Pathologies and Exploratory Use in Proximal Extension to Zone 1\/0 With Chimney Techniques"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7238-6999","authenticated-orcid":false,"given":"Lei","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Vascular Surgery, The Second Xiangya Hospital, Central South University, Changsha, China"},{"name":"The Institute of Vascular Diseases, Central South University, Changsha, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dexiang","family":"Xia","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, The Second Xiangya Hospital, Central South University, Changsha, China"},{"name":"The Institute of Vascular Diseases, Central South University, Changsha, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Quanming","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, The Second Xiangya Hospital, Central South University, Changsha, China"},{"name":"The Institute of Vascular Diseases, Central South University, Changsha, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, The Second Xiangya Hospital, Central South University, Changsha, China"},{"name":"The Institute of Vascular Diseases, Central South University, Changsha, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hao","family":"He","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, The Second Xiangya Hospital, Central South University, Changsha, China"},{"name":"The Institute of Vascular Diseases, Central South University, Changsha, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0936-4420","authenticated-orcid":false,"given":"Chang","family":"Shu","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, The Second Xiangya Hospital, Central South University, Changsha, China"},{"name":"The Institute of Vascular Diseases, Central South University, Changsha, China"},{"name":"State Key Laboratory of Cardiovascular Diseases, Center of Vascular Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3431-226X","authenticated-orcid":false,"given":"Xin","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, The Second Xiangya Hospital, Central South University, Changsha, China"},{"name":"The Institute of Vascular Diseases, Central South University, Changsha, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,3,15]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2019.06.216"},{"issue":"7","key":"e_1_3_2_3_2","article-title":"Hybrid repair versus conventional open repair for aortic arch dissection","volume":"7","author":"Kavanagh EP","year":"2021","unstructured":"Kavanagh EP, Sultan S, Jordan F, et al. Hybrid repair versus conventional open repair for aortic arch dissection. Cochrane Database Syst Rev. 2021;7(7):CD012920.","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2020.05.076"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11748-017-0817-6"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.avsg.2023.04.016"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2023.05.014"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.21470\/1678-9741-2021-0597"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2021.09.020"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2023.07.048"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1177\/15266028231224249"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1097\/JS9.0000000000002029"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2020.08.022"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2018.09.005"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.3390\/jpm12081279"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.3389\/fcvm.2023.1144751"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmbbm.2019.103549"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1038\/labinvest.2011.57"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1177\/1526602817698702"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.21037\/jtd-21-183"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.medengphy.2019.12.002"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.21037\/jtd.2018.06.105"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.avsg.2019.02.005"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.116.004649"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2023.12.025"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2019.08.236"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2023.11.047"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2018.12.010"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2018.03.020"}],"container-title":["Journal of Endovascular Therapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15266028261433405","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/15266028261433405","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15266028261433405","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T21:32:24Z","timestamp":1777498344000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/15266028261433405"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,15]]},"references-count":28,"alternative-id":["10.1177\/15266028261433405"],"URL":"https:\/\/doi.org\/10.1177\/15266028261433405","relation":{},"ISSN":["1526-6028","1545-1550"],"issn-type":[{"value":"1526-6028","type":"print"},{"value":"1545-1550","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,15]]},"article-number":"15266028261433405"}}