# Single center experience with a novel single-branched thoracic stent graft

## TL;DR

This paper presents a single-center experience using a new off-the-shelf branched stent graft to treat aortic lesions without covering the left subclavian artery.

## Contribution

The study introduces a novel off-the-shelf single-branched stent graft for LSA reconstruction during TEVAR.

## Key findings

- The GORE® TAG® TBE was successfully used in 12 patients to treat various aortic lesions.
- The device allows for LSA preservation, reducing complications associated with LSA coverage.
- The stent graft is suitable for both emergency and planned procedures.

## Abstract

Thoracic endovascular aortic repair (TEVAR) has been a feasible treatment option since the first stent graft was approved by the FDA in 2005, and is now the recommended method for treating most descending aorta pathology in the current clinical practice guidelines. Indications for TEVAR include descending aorta aneurysms, traumatic aortic injury and pathology that presents as acute aortic syndrome. More often than not the lesion that needs to be excluded is quite close or contains the distal aortic arch, thus requiring the coverage of the left subclavian artery (LSA) origin, a practice that has been associated with severe complications. Contraindications to LSA coverage resulted in the development of various surgical and endovascular LSA revascularization techniques.

Branched stent grafts containing a single branch for the LSA are a rapidly evolving technology regarding LSA reconstruction during TEVAR. The aim of this article is to demonstrate our center’s experience using a novel off-the-shelf single-branched stent graft, the GORE® TAG® Thoracic Branch Endoprosthesis (TBE) (W. L. Gore & Associates, Inc, Flagstaff, Ariz, USA). The GORE® TAG® TBE is commercially available in Europe since early 2024. We have so far, since February 2024, treated 12 patients using this endograft, successfully treating all types of aortic lesions.

Branched TEVAR is becoming a feasible option for treating descending aorta pathology, without covering the LSA. Moreover, the development of off-the-shelf branched stent grafts, enables physicians to treat patients in the emergency setting, aside from planned procedures.