Concave Supra-arch Branched Stent-Graft System for Endovascular Treatment of Aortic Arch Diseases

The physician must strictly adhere to the clinical study protocol and shall not deviate from or substantially alter it. However, in cases of emergency where there is an immediate risk to the subjects that must be eliminated immediately, a report may be submitted in written form afterward. During the study, any amendments to the clinical study protocol, informed consent documents, requests for deviation, and the resumption of a suspended clinical study must receive written approval from the Ethics Committee.

Inclusion criteria

• Patients who are aged 18 to 80 years inclusive；
• Patients diagnosed with aortic arch aneurysms or penetrating ulcers that require intervention, and for whom the proximal end of the stent needs to be anchored in the Z0 zone;
• Anatomical criteria, including:

• Ascending aorta length is greater than or equal to 50 mm (distance from aortic sinus to anterior edge of innominate artery);
• The diameter range of the anchoring area at the proximal end of the main body is between 25-45 mm and the length is greater than or equal to 30 mm;
• The diameter of the anchored area of supra-arch branch vessels (innominate artery, left common carotid artery, left subclavian artery) is between 5-18 mm, distal anchorage length is greater than or equal to 15 mm;
• Distance between the anterior edge of the innominate artery to the posterior edge of the left subclavian artery is less than or equal to 80 mm;
• Have a suitable iliac, femoral, and superior arch arterial access;
• At least two researchers should assess that the subject is a high-risk patient for surgical treatment or has significant contraindications to surgery. It is recommended to refer to the following criteria: a score of ≥6 in the European System for Cardiac Operative Risk Evaluation (EuroSCORE) scoring system.;
• Patients who understand the purpose of the study, volunteer to participate and sign the informed consent form, and are willing to complete follow-up visits as required by the protocol.

Exclusion criteria

• Patients either with ruptured or infected aneurysms;
• Patients with aortic dissection;
• Patients with general or local infections that may increase the risk of endovascular graft infection;
• Patients with severe stenosis, calcification, or mural thrombus in the stent anchoring area, which is likely to impede stent-graft adherence or affect stent patency;
• Previous endovascular intervention involving the aortic arch;
• Underwent open or endovascular surgery for abdominal aorta within the past 3 months;
• Patients with a history of stroke within the past 3 months (excluding TIA);
• Patients with aneurysms involving the distal descending aorta and requiring reconstruction of important visceral branch vessels within the abdomen;
• Patients with a history of myocardial infarction within the past 3 months;
• Patients with congestive heart failure - NYHA Class IV;
• Patients allergic to contrast agents, stent and delivery system materials (such as nitinol, polyester, PTFE, nylon polymer materials);
• Patients with contraindications to anticoagulant or antiplatelet drugs;
• Patients unable to tolerate general anesthesia;
• Patients with abnormal liver and kidney function before surgery (ALT or AST more than 5 times the upper limit of normal; serum creatinine (Cr) >150umol/L);
• Patients with connective tissue diseases, such as Marfan syndrome, Ehlers-Danlos syndrome, or Behcet's disease;
• Patients with arteritis;
• Patients with a life expectancy of less than 1 year;
• Women who are planning to conceive, pregnant or breastfeeding;
• Patients deemed by the investigator as unsuitable for endovascular treatment;
• Patients who have participated in other clinical studies and have not withdrawn or been excluded within the 3 months prior to the screening period of this study.