Objective:To investigate the clinical application and effects of Castor stent combined with in vitro pre-fenestration technique in treating aortic arch aneurysms involving Z1 and Z2 zones.Methods:Thirty-two pa-tients with aortic arch aneurysms who underwent Castor stent surgery from June 2021 to June 2023 were retro-spectively analyzed.There were 14 patients with true aortic arch aneurysms and 18 patients with dissected aortic arch aneurysms.The Castor stent branch was applied to the left subclavian artery only and was not combined with other operations as the simple surgery group(n=23).The Castor stent branch was applied to the left common ca-rotid artery and the left subclavian artery was reconstructed as the fenestration surgery group(n=9).Results:The surgical success rate of 32 patients was 100％.Postoperative complications occurred in 1 case(1/32,3.12％),which occurred in the fenestrated surgery group(1/9,11.11％).Cerebral infarction occurred in the patient one day after surgery and was manifested as decreased muscle strength of the right lower limb(grade 0/1 muscle strength).All patients were followed up for 1-24.4 months,with a median time of 8 months.During the follow-up period,1 patient died(1/32,3.12％),which occurred in the simple surgery group(1/23,4.35％).The pa-tient was diagnosed with esophageal cancer before surgery and died 2 years after surgery due to malnutrition and multiple organ failure.The internal diameter of the thoracic aorta was(35.3±4.6)mm in the simple surgery group and(33.2±3.9)mm in the fenestrated surgery group,which were significantly lower than those before sur-gery(both P＜0.05).Conclusion:The castor stent technique combined with the fenestration technique in treating aortic arch tumors involving Z1 and Z2 zones has a definite therapeutic effect and certain safety.
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