Quantitative Shape Analysis Supports the Use of Aortic Arch Stent Grafts in Complex Aortic Geometries

Nexus Aortic Arch Stent Graft achieved higher TEVAR success than traditional TEVAR in 27 vs 37 patients, with success rates of 85.2% vs 51.4% (p = 0.005).

• Why it matters: Traditional TEVAR distal landing zones may underperform in complex aortic anatomies, leaving uncertainty about which patients benefit from proximal ascending landing strategies.
• What they did: Pre-operative CTs from 27 Nexus and 37 traditional TEVAR patients were mapped into a size-invariant shape feature space using fluctuation in total integrated Gaussian curvature, alongside mean radius and tortuosity index, with TEVAR failure defined by reintervention or death from aneurysmal growth, endoleak, dissection extension, or rupture.
• The result: Traditional TEVAR success was lower in patients with elevated and large mean radius, while Nexus showed favorable outcomes even with similarly elevated radius; chronic dissections clustered in the high /radius zone (78.3%) and isolated aneurysms in the low /radius zone (70.6%, p < 0.001).