Guo's Endovascular Aortic Arch Replacement of Aortic Dissection by WeFlow-Tribranch Endoprothesis: a Multicenter Pilot Study(GRAFT Study)

Inclusion Criteria:

1. Patients aged 18 to 80 years old.
2. The patient was diagnosed with subacute or chronic aortic arch dissection, or Aorticarch aneurysms.
3. Patients showing a suitable vascular condition, including:
4. Ascending aorta length greater than 50 mm (from the aortic sinusoid junction tothe proximal cardiac margin of the innominate artery).
5. Ascending aorta diameter ≥ 24 mm and ≤ 48 mm;
6. Proximal anchoring zone length ≥ 30 mm;
7. Innominate artery diameter ≤ 24 mm and ≥ 7 mm, length ≥ 20 mm；
8. Left common carotid artery or left subclavian artery diameter ≤ 24 mm and ≥ 7 mm,length ≥ 20 mm；
9. Suitable arterial access for endovascular interventional treatment ;
10. Patients able to understand the purpose of the trial, participate in the trialvoluntarily with informed consent form signed by the subject him/herself or his or herlegal representative, and willing to complete follow-up visits as required under theprotocol.
11. Patients evaluated by at least two vascular surgeons or cardiac surgeons as highsurgical risk patients or deemed to have significant surgical contraindications. (Therecommended reference criteria are: EuroSCORE score ≥ 6, or CFS score > 4, or ASAgrade 3-4, or there are other high-risk surgical factors that affect the prognosis ofthe subject, such as patients with a history of open surgery, other high-risk factorsjudged by a physician team, or patients who refuse open surgery.)

Exclusion Criteria:

1. Patients that have experienced systemic infection during past three months;
2. Neck surgery was performed within three months;
3. Infectious aortic disease、Takayasu arteritis，Marfan syndrome (or other connectivetissue diseases );
4. Patients with severe stenosis, calcification, thrombosis or tortuosity of theBrachiocephalic trunk, Left common carotid artery or left subclavian artery;
5. Heart transplant patients;
6. Patients that have suffered MI or stroke during past three months;
7. Patients with Class IV heart function (NYHA classification) or LVEF<30%
8. Active peptic ulcers or upper gastrointestinal bleeding occurring within the previousthree months;
9. Hematological abnormality, defined as follows: Leukopenia (WBC < 3 × 109/L), acuteanemia (Hb < 90 g/L); thrombocytopenia (PLT count < 50 × 109/L);
10. Patients with renal insufficiency， serum creatinine > 150 umol/l (or 3.0 mg/dl) and /or end-stage renal disease requiring renal dialysis shall be determined by theinvestigator after comprehensive analysis;
11. Subjects with severe liver dysfunction and ALT or AST exceeding 3 times the upperlimit of normal; Subjects whose serum total bilirubin (STB) exceeds 2 times the upperlimit of normal;
12. Patients with intestinal necrosis and lower limb ischemic necrosis;
13. Paraplegic patients;
14. Patients that are pregnant or breastfeeding;
15. Patients with allergies to contrast agents;
16. Patients with a life expectancy of less than 12 months;
17. Patients currently participating in other drug or device research;
18. Any other disease or abnormality that the investigators believe may hinderendovascular interventional treatment.