Comparison of the novel Ankura Plus stent and Castor stent for the treatment of Stanford type B aortic dissection with an insufficient proximal anchoring area.

OBJECTIVE: To compare the efficacy and safety of the Ankura Plus and Castor stents in Stanford type B aortic dissection (TBAD) with an insufficient proximal anchoring area. METHODS: Between January 2020 and October 2022, 54 patients with TBAD were enrolled, including 16 patients with Ankura Plus stents and 38 patients with Castor stents. Data from the two stents were retrospectively analyzed. RESULTS: The surgical success rate for both stents was 100%, and no endoleaks or deaths occurred during hospitalization. The Ankura Plus stent group had a longer surgery time than the Castor stent group (122.6±5.1 vs. 103.7±10.0, P ＜0.001). After an average follow-up of 12 months, the patency rates of the main and branch stents were 100% in both groups. The diameter of the true lumen (TL) was significantly increased, the diameter of the false lumen (FL) was reduced, and there was no statistically significant difference in the probability of complete thrombosis of the FL (68.8% vs. 67.6%, P=0.993). There were no significant differences in the incidences of renal failure (6.3% vs. 8.1%, P = 0.814), stroke (6.3% vs. 2.7%, P = 0.520), or endoleaks (6.3% vs. 10.5%, P = 0.621) between the Ankura Plus and Castor stent groups. One patient in the Castor stent group underwent reintervention because of a type I endoleak three months after surgery. One patient in the Ankura Plus stent group had an additional covered stent placed after one month due to distal TL stenosis of the main stent. One patient in the Castor stent group died of renal failure four months after surgery. CONCLUSION: Both the Ankura Plus and Castor stents are feasible, safe, and effective in the treatment of TBAD with an insufficient proximal anchoring area. Additional long-term studies are required to evaluate the robustness and applicability of Ankura Plus stents.