Custom Made Candy Plug for Distal False Lumen Occlusion in Aortic Dissection: International Experience

Eleshra, Ahmed; Haulon, Stéphan; Bertoglio, Luca; Lindsay, Thomas F.; Rohlffs, Fiona; Dias, Nuno; Tsilimparis, Nikolaos; Panuccio, Giuseppe; Kölbel, Tilo; Mougin, Justine; Chiesa, Roberto; Salvati, Serafina; Nyman, Johan; Sonesson, Björn; Reeps, Christian; Lutz, Brigitta; Trimarchi, Santi; Lomazzi, Chiara; Sobocinski, Jonothan; Kerezsy, Michael; Rijswijk, Catharina S.P. van; Schaik, J. van; Pfister, Karin; Mialhe, Claude; Tielliu, Ignace F.J.; Modarai, Bijan; Florek, H.-J.; Jakimowicz, Tomasz; Cheng, Stephen Z. D.

doi:10.1016/j.ejvs.2023.03.020

Cited by 10 publications

(4 citation statements)

References 27 publications

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“… 25 For chronic aneurysms, the Hamburg group has described the use of controlled disruption with a thoracic stent graft designed with a larger flared diameter (“knickerbocker”) or, more recently, a false lumen occlusion device (“candy-plug”). 21 , 24 , 26 , 27 The latter option has gained increasing popularity in European centers but remains investigational. Eleshra and colleague 26 reported a series of 155 patients treated for chronic postdissection thoracic aneurysms using TEVAR with a false lumen occlusion device, achieving stability or a decreased aneurysm diameter in 96%, which compares favorably to other endovascular series.…”

Section: Discussionmentioning

confidence: 99%

“… 21 , 24 , 26 , 27 The latter option has gained increasing popularity in European centers but remains investigational. Eleshra and colleague 26 reported a series of 155 patients treated for chronic postdissection thoracic aneurysms using TEVAR with a false lumen occlusion device, achieving stability or a decreased aneurysm diameter in 96%, which compares favorably to other endovascular series.…”

Section: Discussionmentioning

confidence: 99%

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Transcatheter electrosurgical septotomy technique for chronic postdissection aortic aneurysms

Baghbani-Oskouei,

Savadi,

Mesnard

et al. 2024

Journal of Vascular Surgery Cases, Innovations and Techniques

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Transcatheter electrosurgical septotomy technique for chronic postdissection aortic aneurysms

Baghbani-Oskouei,

Savadi,

Mesnard

et al. 2024

Journal of Vascular Surgery Cases, Innovations and Techniques

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“…This technique for false lumen embolization in the distal thoracic segment is the only one with greater scientific evidence to support it (Figure 5). In a multicentric retrospective study of 155 patients treated with a custom-made candy plug device (Cook Medical, Bloomington, IN, USA), 77% achieved early complete false lumen thrombosis, and only 4% experienced false lumen enlargement over time [34]. In the past and still today in certain settings, physician-modified thoracic endografts have been used to serve the same purpose [35,36].…”

Section: Embolization In Aortic Dissectionmentioning

confidence: 99%

Plug-Based Embolization Techniques of Aortic Side Branches during Standard and Complex Endovascular Aortic Repair

Melloni,

D’Oria,

Dioni

et al. 2024

JCM

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Vascular plugs are an evolving family of vessel occluders providing a single-device embolization system for large, high-flow arteries. Nitinol mesh plugs and polytetrafluoroethylene membrane plugs are available in different configurations and sizes to occlude arteries from 3 to 20 mm in diameter. Possible applications during complex endovascular aortic procedures are aortic branch embolization to prevent endoleak or to gain an adequate landing zone, directional branch occlusion, and false lumen embolization in aortic dissection. Plugs are delivered through catheters or introducers, and their technical and clinical results are comparable to those of coil embolization. Plugs are more accurate than coils as repositionable devices, less prone to migration, and have fewer blooming artifacts on postoperative computed tomography imaging. Their main drawback is the need for larger delivery systems. This narrative review describes up-to-date techniques and technology for plug embolization in complex aortic repair.

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“…Embolization of the false lumen at the level of the distal descending aorta in chronic aortic dissection is a less invasive but also effective approach. In recent years, the candy-plug technique, which uses a customized stent graft to seal off the distal false lumen, has been shown to be both technically feasible with encouraging early and late outcomes [ 2 ]. In this report, we successfully modified this technique that made midsection tapering down unnecessary by using an atrial septal defect occluder instead to embolize residual arterial flow in the aortic false lumen.…”

Section: Introductionmentioning

confidence: 99%

Atrial septal defect occluder combined with stent graft for the management of post-dissection aortic aneurysm previously treated with unsuccessful coils: a case report

Wang,

Wei,

et al. 2023

CVIR Endovasc

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Background Although the candy-plug technique has been reported to be useful for the treatment of post-dissection aortic aneurysm, the stent graft needs be to customized to accommodate the size of vascular occluders. Case presentation We present a case of a persistent false lumen successfully treated with endovascular stent-graft and atrial septal defect occluder in a patient with Stanford Type B dissection. A covered stent graft was implanted into the false cavity through a distal rupture, and an atrial septal defect occluder was inserted into the covered stent to seal of the false cavity. Decreased aneurysmal diameter and false lumen thrombosis were noted by CT scan at 6-month follow-up. Conclusions Our case showed that combined use of a stent graft and atrial septal defect occluder is safe, technically feasible and effective in sealing of the false lumen in post-dissection aortic aneurysm patients with previously failed false lumen thrombosis.

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Custom Made Candy Plug for Distal False Lumen Occlusion in Aortic Dissection: International Experience

Cited by 10 publications

References 27 publications

Transcatheter electrosurgical septotomy technique for chronic postdissection aortic aneurysms

Transcatheter electrosurgical septotomy technique for chronic postdissection aortic aneurysms

Plug-Based Embolization Techniques of Aortic Side Branches during Standard and Complex Endovascular Aortic Repair

Atrial septal defect occluder combined with stent graft for the management of post-dissection aortic aneurysm previously treated with unsuccessful coils: a case report

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