Comparative Efficacy of Integrated Stent-Graft versus Conventional Covered Stent-Graft Alone in Type B Aortic Dissection: A Retrospective Study Focusing on Aortic Remodeling and Branch Perfusion.

Background: To compare the early efficacy of an integrated stent-graft (16-cm covered stent combined with a 6-cm distal bare stent) versus a conventional covered stent-graft alone in patients with acute type B aortic dissection (TBAD), with a focus on aortic remodeling and branch artery perfusion. Methods: In this single-center retrospective cohort study, 102 patients were included (integrated stent-graft: n = 34; conventional stent-graft: n = 68). Aortic remodeling was assessed using the true lumen area ratio at five predefined anatomical planes. Branch artery perfusion patterns and procedure-related complications were evaluated preoperatively and at 3-month follow-up. Results: At 3 months, the integrated stent-graft group demonstrated significantly higher true lumen area ratios at the left subclavian artery plane 0.60 (0.41, 0.63) vs. 0.41 (0.25, 0.54), Conclusions: In this exploratory retrospective study with short-term (3-month) follow-up, the integrated stent-graft system was associated with improved early true lumen remodeling in the proximal and mid-aortic segments and differences in branch artery perfusion patterns compared with a conventional covered stent-graft alone. A trend toward fewer new entry tears was observed, but given the limited follow-up and sample size, these findings should be considered preliminary. Confirmation in larger prospective studies with long-term follow-up is warranted to determine whether these early imaging changes translate into durable clinical benefit.