RS15 - Multicenter Evaluation of Aortic Remodeling and Clinical Outcomes After Zone 2 Single-Branched Endograft Repair for Type B Aortic Dissection

Friday, June 12, 2026

8:23 AM - 8:30 AM ET

Location: Hynes CC, Third Level, Ballroom B

Submitting & Presenting Author(s)

Elizabeth L. Chou, MD (she/her/hers)

Assistant Professor, Vascular Surgery
Cedar-Sinai
Los Angeles, California

Co-Author(s)

ND

Nimesh D. Desai

Director, Penn Aorta Center; Associate Professor of Surgery
Division of Cardiac Surgery, Hospital of the University of Pennsylvania
Philadelphia, Pennsylvania
Joseph E. Bavaria, MD
WB

William T. Brinkman
Dennis R. Gable, MD

Texas Vascular Associates
Plano, Texas
Jon S. Matsumura, MD

University of Colarado
Silverthorne, Colorado
Fernando Fleischman

associate professor of surgery
Keck school of medicine
los angelles, California
Sukgu M. Han, MD, MS (he/him/his)

Professor of Surgery and Chief, Division of Vascular Surgery and Endovascular Therapy
Keck Medical Center of Univerisity of Southern California
Los Angeles, California
JP

Jean Panneton
BT

Bradley Taylor
Bradley G. Leshnower, MD

Assistant Professor of Surgery
Emory University
Atlanta, Georgia
Joseph S. Coselli, MD

Chief, Division of Cardiothoracic Surgery Cullen Foundation Endowed Chair
Baylor College of Medicine
Houston, TX
Michael D. Dake, MD

Senior Vice President for Health
University of Arizona Health Sciences, Tucson, AZ
Tucson, Arizona
HP

Himanshu J. Patel, MD

Joe D. Morris Collegiate Professor of Cardiac Surgery
University of Michigan Medical Center
Ann Arbor, Michigan

Senior Author(s)

Ali Azizzadeh, MD

Professor and Director of Vascular Surgery
Cedars-Sinai Medical Center
Los Angeles, California

Objectives: The mid and long-term outcomes of patients with type B aortic dissection (TBAD) after Thoracic Endovascular Aortic Repair (TEVAR) remain incompletely defined. Single-branched endografts (SBE) enable proximal entry tear coverage while preserving left subclavian artery perfusion. It remains unclear whether this strategy promotes favorable aortic remodeling, or merely delays distal degeneration necessitating future reintervention. We evaluated aortic remodeling and clinical outcomes after zone 2 TEVAR with SBE using data from a prospective, non-randomized, multicenter pivotal trial in patients with TBAD.

Methods: Patients were identified from 34 US trial sites and stratified by dissection chronicity and timing of repair: acute dissection (AD ≤14 days from symptom onset); chronic dissection (CD ≥14); or residual dissection (RD) following prior ascending and/or aortic arch repair. Results are described by counts for categorical or averages for continuous data. Core laboratory-adjudicated perioperative and surveillance imaging to 3 years were analyzed for aortic remodeling.

Results: A total of 136 patients with TBAD underwent zone 2 TEVAR with SBE (18.3% AD, 58.1% CD, 23.5% RD). Majority of the cohort (69.9%) had extensive dissection to Zones 9-11. Spinal drain use was common (51.5%) and the SBE was frequently implanted with one or more additional thoracic endografts (69.1%) (Table 1). At 36 months, all-cause mortality was 13% (n=18/136; AD 20%, CD 12%, RD 12%), including 3 lesion-related mortalities (1 AD < 30 days, 2 CD: 1 < 30 days and 1 < 6 months). Eight total strokes occurred (2 < 30 days; 6 >30 days; 3 disabling, 5 RD) with mixed ischemic, embolic and hemorrhagic etiologies. Endoleaks were observed in 5 patients (3 type I; 2 type III), all occurring in CD and RD patients. There was one branch vessel occlusion. There were no aortic ruptures, device migration, compression or wire fractures.

Surveillance imaging demonstrated favorable aortic remodeling across the cohort: >5mm reduction in maximum aortic diameter of the treated segment in 74% of patients, reduction in false lumen, and true lumen expansion (Figure 1). Stability was observed in 18 patients (24%). Reinterventions occurred in 6.6% of cohort (n=9, 7 CD, 2 AD), with four proximal aortic reconstructions, two false lumen embolizations, two distal extensions, and one open repair.

Conclusions: In this multicenter cohort with a high prevalence of extensive distal dissection, Zone 2 TEVAR with SBE was associated with favorable aortic remodeling, low device-related events, excellent branch vessel patency, low lesion-related mortality and reintervention through 3-years of follow up.