{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T00:10:05Z","timestamp":1780445405997,"version":"3.54.1"},"reference-count":20,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T00:00:00Z","timestamp":1775520000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medical Sciences"],"abstract":"<jats:p>Objective: To evaluate early and mid-term outcomes of thoracic endovascular aortic repair (TEVAR) using the Castor single-branched aortic stent graft in a real-world multicenter Italian experience. Methods: This retrospective, nonrandomized, multicenter study included all consecutive patients treated with the Castor stent graft between January 2019 and April 2025 in eight Italian centers. The device was used in patients with thoracic aortic pathologies requiring TEVAR in proximal landing zones 1 or 2. Primary endpoints included technical success, intraoperative major adverse events (MAEs), and deployment accuracy. Secondary endpoints were aortic-related mortality, neurological complications, reinterventions, and endoleaks. Results: Fifty-one patients (mean age 68.8 \u00b1 8 years, 75.5% male) were treated, primarily for type B aortic dissection (45.1%) and thoracic aortic aneurysm (27.5%). Proximal landing was in zone 2 in 92.1% and zone 1 in 7.8% of cases. The technical success rate was 94.1%, with three cases (5.8%) of intraoperative type Ia endoleak. No intraoperative deaths or major adverse events occurred. Two cases of minor embolic stroke (3.9%) were observed, both in zone 1 procedures involving left common carotid artery revascularization. At a median follow-up of 22.3 months (range 2\u201358), no additional endoleaks or neurological events were reported, with 100% branch patency rate. Conclusions: The Castor single-branched stent graft is a feasible option for TEVAR in zone 2, with high technical success and low rates of neurological complications. Accurate case selection and procedural planning are essential.<\/jats:p>","DOI":"10.3390\/medsci14020185","type":"journal-article","created":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T09:40:31Z","timestamp":1775554831000},"page":"185","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Proximal Sealing in Zone 1\u20132 Using the Castor Stent-Graft: Early Results from an Italian Multicenter Registry"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0755-4933","authenticated-orcid":false,"given":"Antonio","family":"Rizza","sequence":"first","affiliation":[{"name":"Fondazione Toscana Gabriele Monasterio, 54100 Massa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4459-9687","authenticated-orcid":false,"given":"Simona","family":"Sica","sequence":"additional","affiliation":[{"name":"Unit of Vascular Surgery, Fondazione Policlinico Universitario A. Gemelli I.R.C.C.S., 00168 Rome, Italy"},{"name":"Division of Vascular Surgery, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2994-449X","authenticated-orcid":false,"given":"Marco","family":"Ferraresi","sequence":"additional","affiliation":[{"name":"Vascular Surgery Unit, Manzoni Hospital, 23900 Lecco, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Tinelli","sequence":"additional","affiliation":[{"name":"Unit of Vascular Surgery, Fondazione Policlinico Universitario A. Gemelli I.R.C.C.S., 00168 Rome, Italy"},{"name":"Division of Vascular Surgery, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7304-7553","authenticated-orcid":false,"given":"Yamume","family":"Tshomba","sequence":"additional","affiliation":[{"name":"Unit of Vascular Surgery, Fondazione Policlinico Universitario A. Gemelli I.R.C.C.S., 00168 Rome, Italy"},{"name":"Division of Vascular Surgery, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8991-6805","authenticated-orcid":false,"given":"Giovanni","family":"Rossi","sequence":"additional","affiliation":[{"name":"Vascular Surgery Unit, Manzoni Hospital, 23900 Lecco, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-9165-7732","authenticated-orcid":false,"given":"Giancarlo","family":"Trimarchi","sequence":"additional","affiliation":[{"name":"Fondazione Toscana Gabriele Monasterio, 54100 Massa, Italy"},{"name":"Interdisciplinary Center for Health Sciences, Scuola Superiore Sant\u2019Anna, 56127 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4604-0871","authenticated-orcid":false,"given":"Ilenia","family":"Foffa","sequence":"additional","affiliation":[{"name":"Fondazione Toscana Gabriele Monasterio, 54100 Massa, Italy"},{"name":"Institute of Clinical Physiology, National Research Council, 54100 Massa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Bastiani","sequence":"additional","affiliation":[{"name":"Fondazione Toscana Gabriele Monasterio, 54100 Massa, Italy"},{"name":"Institute of Clinical Physiology, National Research Council, 54100 Massa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Di Sibio","sequence":"additional","affiliation":[{"name":"Fondazione Toscana Gabriele Monasterio, 54100 Massa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Murzi","sequence":"additional","affiliation":[{"name":"Fondazione Toscana Gabriele Monasterio, 54100 Massa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cataldo","family":"Palmieri","sequence":"additional","affiliation":[{"name":"Fondazione Toscana Gabriele Monasterio, 54100 Massa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola","family":"Tusini","sequence":"additional","affiliation":[{"name":"Vascular Surgery Unit, Arcispedale S. Maria Nuova, 42123 Reggio Emilia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmelo","family":"Ricci","sequence":"additional","affiliation":[{"name":"Interventional Radiology Unit, Siena University Hospital, 53100 Siena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2724-3961","authenticated-orcid":false,"given":"Andrea","family":"Colli","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, Department of Surgical, Medical and Molecular Pathology and Critical Care, University of Pisa, 56127 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Lorido","sequence":"additional","affiliation":[{"name":"Unit of Vascular Surgery, Ospedale Belcolle, 01100 Viterbo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Talarico","sequence":"additional","affiliation":[{"name":"Vascular Surgery Unit, Ospedale Civico di Palermo, 90127 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2995-7458","authenticated-orcid":false,"given":"Mafalda","family":"Massara","sequence":"additional","affiliation":[{"name":"Divisione di Chirurgia Vascolare ed Endovascolare, GOM di Reggio Calabria, 89121 Reggio Calabria, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chang","family":"Shu","sequence":"additional","affiliation":[{"name":"Center of Vascular Surgery, Fuwai Hospital of Chinese Academy of Medical Sciences, Beijing 100037, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5244-0556","authenticated-orcid":false,"given":"Sergio","family":"Berti","sequence":"additional","affiliation":[{"name":"Fondazione Toscana Gabriele Monasterio, 54100 Massa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"SOCIAL Collaborative Study Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1016\/j.ejvs.2018.09.016","article-title":"Editor\u2019s Choice\u2014Current Options and Recommendations for the Treatment of Thoracic Aortic Pathologies Involving the Aortic Arch: An Expert Consensus Document of the European Association for Cardio-Thoracic Surgery (EACTS) & the European Society for Vascular Surgery (ESVS)","volume":"57","author":"Czerny","year":"2019","journal-title":"Eur. 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