West China Hospital Hu Jia Team Completes Thailand's First Minimally Invasive Endovascular Repair for Complex Aortic Arch Dissection

Background

Aortic arch dissection is a serious vascular condition involving a tear in the inner layer of the aorta, the body's main artery carrying blood from the heart. Blood can then flow between the layers of the aortic wall, potentially compromising blood supply to critical branches. The aortic arch itself is anatomically complex, giving rise to three major supra-aortic vessels: the innominate artery, left common carotid artery, and left subclavian artery, which supply the brain, head, neck, and upper limbs. Lesions in this region are considered high-risk due to their location and the potential for stroke, organ malperfusion, or rupture.

Traditional open surgical repair often requires sternotomy, cardiopulmonary bypass, and periods of deep hypothermic circulatory arrest, carrying substantial perioperative risks. Over time, endovascular techniques using stent grafts deployed via blood vessels have evolved as a less invasive option for aortic pathologies. However, achieving precise total endovascular reconstruction of the aortic arch and its three branches in one procedure remains technically demanding and has been described in medical literature as a pinnacle challenge in the field, sometimes referred to as a 'Mount Everest' procedure.

What was achieved

On October 23, 2026, West China Hospital of Sichuan University reported that a team led by Director Physician Hu Jia from its Department of Cardiac and Great Vessel Surgery was invited to Songklanagarind Hospital, affiliated with Prince of Songkla University in Thailand. In collaboration with the local medical team under Dr. Boonprasit, they successfully completed Thailand's first minimally invasive total endovascular multi-branched repair for a complex aortic arch dissection.

The patient had a dissection originating in the innominate artery that extended to involve the aortic arch and continued distally, creating significant technical challenges for standard endovascular approaches. Immediate postoperative angiography confirmed that the entry tear of the innominate artery dissection was fully closed and blood flow through the reconstructed supra-aortic branches was unobstructed, meeting the expected treatment goals. The procedure utilized an innovative multi-branched covered stent system with Chinese independent intellectual property rights. The hospital described the case as a successful example of exporting its experience in complex aortic arch total endovascular minimally invasive repair technology.

How it works

In a total endovascular aortic arch repair, physicians gain access to the vascular system through small punctures, most commonly in the femoral arteries at the groin. Using real-time X-ray imaging (fluoroscopy and angiography), catheters and guidewires are advanced to the site of the dissection. A specialized covered stent graft is then positioned and deployed from within the aorta to reline the vessel, sealing the entry tear and redirecting blood flow into the true lumen while excluding the false channel created by the dissection.

The multi-branched stent system is engineered to address the unique anatomy of the aortic arch. It allows simultaneous reconstruction of the main aortic lumen and the origins of the three supra-aortic branches in a single minimally invasive intervention. The branches of the stent graft are aligned to maintain patency to the innominate, left common carotid, and left subclavian arteries. This approach avoids open surgery on the chest or neck, reduces the need for circulatory arrest, and aims to lower overall procedural trauma. The West China Hospital team has prior experience with similar techniques, including international first applications in post-Bentall procedure cases involving complex arch dissections.

What it means for international patients

The collaboration demonstrates international interest in advanced endovascular techniques for complex aortic diseases developed at specialized Chinese centers. It highlights the accumulated expertise in minimally invasive reconstruction of challenging aortic arch pathologies.

West China Hospital maintains an International Medical Center comprising VIP outpatient clinics, inpatient wards, and a dedicated International Medical Department. This center is designated for care of patients from foreign countries as well as Hong Kong, Macau, and Taiwan. It provides English-language reception and hospitalization services, international consultation and referral support, and cooperates with more than 20 domestic and foreign insurance companies and rescue agencies for appointment and payment services. International patients considering care for aortic conditions should contact the hospital directly to confirm eligibility, as suitability depends on individual medical assessment and current clinical protocols.

About the hospital

West China Hospital of Sichuan University is a comprehensive tertiary Class A academic medical center located in Chengdu, Sichuan Province, China. Affiliated with Sichuan University, its origins trace to 1892 with the establishment of missionary-founded hospitals (Renji and Cunren). It has developed into one of the largest single-site hospitals in the world, with a strong emphasis on clinical care, education, and research.

The hospital is consistently ranked among China's top institutions. According to the Fudan University Hospital Management Institute rankings, it has placed second nationally in recent comprehensive evaluations. It hosts numerous national key clinical specialties, including strengths in cardiovascular surgery. The Department of Cardiovascular Surgery has focused on minimally invasive treatments for complex aortic diseases, with Hu Jia's team contributing multiple reported international first procedures in total endovascular arch repair. The hospital operates an International Medical Center to support overseas patients.