Gore Tag Thoracic Branch Endoprosthesis in Acute Aortic Syndromes: A Case Series

The GORE TAG Thoracic Branch Endoprosthesis (TBE) is a novel CE mark (European Conformity Mark) approved off-the-shelf aortic branched zone 2 device indicated for endovascular repair of the proximal descending thoracic aorta maintaining flow into the left subclavian artery (LSA) with no need for surgical LSA debranching and related risks. This case series describes the use of GORE TAG TBE in 5 consecutive patients urgently treated for acute aortic syndromes at our center between February and May 2024. Two had zone 3 thoracic aorta aneurysms with interscapular pain, and 3 others presented with acute complicated type B aortic dissections—one of which showed signs of impending rupture, and 2 experienced renal malperfusion. The main endograft was deployed on a superstiff guidewire placed in ascending aorta and a through and through guidewire in the LSA. The side branch bridging stent was released over the through and through system with no complications. Operating mean time was 122 minutes. All procedures were uneventful with no cases of neurological and cardiac events. Technical success was achieved in all cases with satisfactory results at 3 months CTA follow-up. Our early experience with the use of GORE TAG TBE has been effective and uneventful even in urgent settings regardless of its novelty in Europe. Clinical impact The GORE TAG Thoracic Branch Endoprosthesis (TBE) represents an interesting novelty in the management of thoracic aortic pathologies, particularly in urgent settings where left subclavian artery (LSA) coverage is required. By eliminating the need for additional LSA revascularization procedures, this device aims to reduce procedural complexity, operating time, and the risk of complications associated with traditional methods. Clinicians can achieve effective treatment with a single, off-the-shelf device, improving both patient outcomes and procedural efficiency. This case series highlights the potential of an off-the-shelf single-branched thoracic endograft in urgent settings.