ArticleJTCVS structural and endovascular2026
Three-year outcomes of endovascular repair of descending thoracic aortic lesions with a single-branched endograft for left subclavian artery preservation.
Article in JTCVS structural and endovascular, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: Zone 2 thoracic endovascular aortic repair with a single-branched endograft (GORE TAG Thoracic Branch Endoprosthesis [TBE], W.L. Gore & Associates, Inc) was approved by the Food and Drug Administration in May 2022 on the basis of 1-year results from a pivotal trial. This report presents 3-year trial outcomes in patients with nondissection descending thoracic aortic lesions requiring zone 2 proximal landing zone. Methods: In this prospective, nonrandomized cohort study across 40 US sites, 106 adults underwent thoracic endovascular aortic repair using the TBE device, which includes a side-branch for left subclavian artery perfusion. Three cohorts were evaluated: aneurysm (AN; n = 84), traumatic aortic injury (TAI; n = 9), and other isolated lesions (OL; n = 13). Results: Mean ages were AN 70 ± 11, TAI 42 ± 19, and OL 65 ± 13 years; male patients comprised 63%, 89%, and 46%, respectively. At 36 months, all-cause mortality was 14% overall (AN 13%, TAI 0%, OL 31%) with 1 lesion-related death (1%). Late (>30 days) stroke occurred in 5%. Core laboratory-adjudicated imaging follow-up revealed 8% type I/III endoleaks and 99% left subclavian artery branch patency. Aortic enlargement (>5 mm) was observed in 5% (all in AN cohort; none requiring reintervention), with no instances of aortic rupture, device migration, or wire fracture reported. Late reinterventions were required in 7% of patients, all in the AN group. Conclusions: At 3 years, the TBE device demonstrated durable outcomes for nondissection descending thoracic aortic disease, with high branch patency, low lesion-related mortality, and minimal complications across diverse pathology cohorts. These results support its role as a safe, effective alternative to surgical revascularization in anatomically suitable zone 2 cases.
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