Experience of the Zenith Dissection Endovascular System in the emergency setting of malperfusion in acute type B dissections

Abstract

Used as a treatment for organ malperfusion complicating acute type B dissections, the Zenith Dissection Endovascular System achieved safely and effectively satisfactory clinical results in the short term. The long-term effect of this composite treatment on aortic remodelling remains to be determined.

Modified Petticoat Technique with Pre-placement of a Distal Bare Stent Improves Early Aortic Remodeling after Complicated Acute Stanford Type B Aortic Dissection

“…Since FL thrombosis is related to freedom from long-term dissection related mortality, 36 techniques to enhance FL thrombosis are critical to achieve long-term durability of TEVAR. Fenestrated or branched stent grafts may enhance FL exclusion and thrombosis, 28,38 but use of this technology in the dissected aorta is very limited and poses particular challenges. Use of a covered stent distally, covering the entire thoracic aorta to the celiac trunk, could increase the rate of neurological complications such as spinal cord ischemia.…”

Contemporary Management of Acute Type B Dissection

“…Dissection-specific stent systems have been developed and are undergoing evaluation. 32 In patients with suspected mesenteric ischaemia, it is often prudent to perform a subsequent laparotomy to excise any frankly dead gut, with exteriorisation of the distal end as a stoma or simple resection without anastomosis with a view to re-exploration in 24e48 hours. A second look laparotomy for further excision and definitive treatment is often necessary.…”

Operative Results and Clinical Features of Chronic Stanford Type B Aortic Dissection: Examination of 234 Patients Over 6 Years

“…Alsac et al performed TEVAR for acute complicated TBAD and achieved satisfactory early outcomes. 7 Similarly, Patel et al and Shah et al also reported on TEVAR for complicated TBAD 8,9 ; where the 30 day mortality rate was 17.4%, and mean survival was 84.3 months. In addition they found that, while the risk of late mortality was associated with age, no association was observed for either the type or the number of malperfused vessels.…”