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Cardiovasc. Med."],"abstract":"<jats:p><jats:bold>Objective:<\/jats:bold> To examine the feasibility, integrity, efficacy, and safety of endovascular repair of the aortic arch pathologies with the mini-cross prefenestration (MCPF) on stent grafts.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> First, to prove the feasibility of the MCPF, an <jats:italic>in-vitro<\/jats:italic> prefenestration experiment was conducted. Second, to examine the integrity of the MCPF stent grafts, a fatigue test was conducted. Then, the membranes and metal structures of stent grafts were examined by light microscopy and scanning electron microscopy (SEM). Third, a clinical experiment was conducted to investigate the efficacy and safety of this novel technique (<jats:ext-link>ClinicalTrials.gov<\/jats:ext-link> Identifier: NCT04544579).<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> All the 12 branch stents were successfully implanted and flared <jats:italic>in vitro<\/jats:italic>. After the fatigue test stimulating a 5-year cardiac cycle, no obvious disintegration or fracture was found in light microscopy or SEM. From December 2017 to February 2020, 26 patients with left subclavian arteries and\/or left common carotid arteries involved received the novel technique. The endovascular repair with the MCPF was successfully performed on all the 26 (100%) patients. Eighteen (69.2%) patients underwent the reconstruction of the left subclavian artery (LSCA) only. The fenestrations of both the LSCA and left common carotid artery (LCCA) were conducted in 8 (30.8%) patients. Median operative time was 120 [interquartile range (IQR), 95\u2013137.5] min and median revascularization time of the LSCA and LCCA was 30.5 (IQR, 22.8\u201342.0) s and 20.0 (IQR, 18.0\u201332.0) s separately. During the median follow-up duration of 38.9 (range, 18.8\u201344.2) months, one case needed an open surgery because of retrograde type A aortic dissection 3 months after implantation and no other complications or mortality occurred. The maximum aortic diameters were significantly decreased in patients with thoracic aortic dissection and thoracic aortic aneurysm (<jats:italic>p<\/jats:italic> &amp;lt; 0.05).<\/jats:p><jats:p><jats:bold>Conclusion:<\/jats:bold> The existing evidence demonstrated the safety, rapid branch artery revascularization, and positive aortic remodeling of the novel technique. Long-term observation is warranted to prove the durability.<\/jats:p>","DOI":"10.3389\/fcvm.2021.745871","type":"journal-article","created":{"date-parts":[[2022,1,11]],"date-time":"2022-01-11T04:56:28Z","timestamp":1641876988000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["The Mini-Cross Prefenestration for Endovascular Repair of Aortic Arch 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