Intentional Targeted False Lumen Occlusion after Aortic Dissection: A Systematic Review of the Literature

Σπανός, Κωνσταντίνος; Kölbel, Tilo; Rohlffs, Fiona; Heidemann, Franziska; Giannoukas, Athanasios D.; Debus, Sebastian; Tsilimparis, Nikolaos

doi:10.1016/j.avsg.2018.08.086

Cited by 42 publications

(25 citation statements)

References 41 publications

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“…False lumen coil embolization appears to be a safe procedure, with none of our patients experiencing coilrelated complications. Spanos et al 16 also suggested that false lumen embolization is a safe procedure in cTBAD, with a 0% 30-day mortality and a 7.1% late mortality. However, no study to date has commented on spinal cord ischemia in false lumen embolization.…”

Section: Discussionmentioning

confidence: 98%

“…14,15,17,18 Coil embolization of the false lumen has been used as another method of encouraging thrombosis, but fewer than 100 cases have been reported in the literature. 16,19,20 In patients with a larger false lumen relative to total aortic diameter, coil embolization may be preferred to the knickerbocker technique. Coils placed into the false lumen could provide less potential for stent graft injury than overexpanding a graft into a large false lumen.…”

Section: Discussionmentioning

confidence: 99%

“…The candy-plug technique deploys a modified covered stent graft into the false lumen, followed by an Amplatzer vascular plug (Abbott, St. Paul, Minn) at the waist to occlude flow. [14][15][16] However, this graft can lead to true lumen narrowing or stent-induced wall injury. 14,15,17 The knickerbocker technique involves inflation of a balloon inside of an oversized stent graft, causing a controlled rupture of the dissection flap and occluding false lumen flow.…”

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confidence: 99%

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False lumen embolization as a rescue technique in the setting of acute and chronic dissecting aneurysms as adjunct to thoracic endovascular aortic repair

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Feghali

Nguyen

et al. 2020

Journal of Vascular Surgery Cases, Innovations and Techniques

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Complicated type B aortic dissection (TBAD) is a life-threatening condition requiring surgical intervention. One such complication in the acute or chronic setting is aneurysmal degeneration. The dissected aortic wall is weakened, and the pressures in the false lumen are often high. In the past decade, thoracic endovascular aortic repair (TEVAR) has become the treatment of choice for TBAD. TEVAR can be complicated by lack of false lumen thrombosis, increasing the risk of death. We present three cases of TBAD with patent false lumens after TEVAR that were treated by false lumen coil embolization. (J Vasc Surg Cases and Innovative Techniques 2020;6:110-7.)

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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False lumen embolization as a rescue technique in the setting of acute and chronic dissecting aneurysms as adjunct to thoracic endovascular aortic repair

Rakestraw

Feghali

Nguyen

et al. 2020

Journal of Vascular Surgery Cases, Innovations and Techniques

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“…The 7-F Ansel sheath is now retracted into the LSA, which is catheterized proximally, and the sheath is used to occlude the proximal LSA with vascular plugs and/or coils in standard technique, preserving the left vertebral artery ( Figure 8B). Finally, any planned distal components, including false lumen occlusion with the Candy-Plug 19 or other techniques in cases of aortic dissection, 20 are placed and angiography is performed to confirm the final result before closing access arteries and wounds.…”

Section: Catheterization Of the Inner Branchesmentioning

confidence: 99%

Technical Aspects of Branched Thoracic Arch Graft Implantation for Aortic Arch Pathologies

et al. 2020

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Purpose: To describe the implantation steps and tips and tricks for the Inner Branch Arch Endograft designed to treat aortic arch aneurysm and chronic type A aortic dissection. Technique: Anatomical suitability criteria should be met in order to use this device. The proximal segment of the graft lands in the ascending aorta distally to the sinotubular junction and the distal segment lands in the descending aorta. The device includes 2 inner branches; the proximal branch is used for a connection to the innominate artery (positioned slightly posterior at 12:30 o’clock), while the second branch is positioned slightly anterior at 11:30 o’clock and is used as a connection to the left common carotid artery. Access, implantation technique, deployment of the device, and catheterization of the branches are described thoroughly. Conclusion: This Inner Branch Arch Endograft is an appealing alternative to treat aortic arch pathology, especially in patients unsuitable for open repair. Nevertheless, complex aortic arch repair is associated with a learning curve. Meticulous preoperative planning and a high level of concentration intraoperatively are mandatory.

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“…Postdissecting aneurysms limited to the descending thoracic aorta have been managed with thoracic FL occlusion techniques such as the Candy-Plug (CP) and the knickerbocker techniques. [4][5][6] Conversely, postdissecting aneurysms extending through the entire thoracoabdominal aorta (TAAA) have been successfully treated with fenestrated or branched stent-grafts. [7][8][9][10] This technical note proposes the use of a combined approach with prior intentional occlusion of the thoracic FL with a CP occluder, followed by fenestrated or branched endovascular exclusion of the postdissecting TAAA as a staged procedure in order to precondition the spinal cord.…”

Section: Introductionmentioning

confidence: 99%

Staged Fenestrated/Branched Repair of Postdissecting Thoracoabdominal Aneurysm With Candy-Plug False Lumen Occlusion for Spinal Cord Preconditioning

et al. 2020

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Purpose: To describe a possible application of thoracic false lumen occlusion techniques with a Candy-Plug occluder to induce false lumen thrombosis for preconditioning the spinal cord during staged fenestrated repair of postdissecting thoracoabdominal aneurysms. Technique: A Candy-Plug occluder is deployed within the thoracic false lumen after proximal entry tear coverage with a standard thoracic stent-graft during staged repair of postdissecting thoracoabdominal aneurysms. The blockade of thoracic false lumen retrograde reperfusion from distal entry tears induces a controlled thrombosis of both the thoracic false lumen and intercostal arteries. Then, when the fenestrated device is delivered 4 to 6 weeks later, the procedure is completed with standard techniques according to the staging protocols of individual centers. Conclusion: A new possible application of a Candy-Plug false lumen occlusion technique might be an intermediate procedure aimed at preconditioning the spinal cord by occluding the thoracic false lumen during complex staged fenestrated thoracoabdominal repairs.

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Intentional Targeted False Lumen Occlusion after Aortic Dissection: A Systematic Review of the Literature

Cited by 42 publications

References 41 publications

False lumen embolization as a rescue technique in the setting of acute and chronic dissecting aneurysms as adjunct to thoracic endovascular aortic repair

False lumen embolization as a rescue technique in the setting of acute and chronic dissecting aneurysms as adjunct to thoracic endovascular aortic repair

Technical Aspects of Branched Thoracic Arch Graft Implantation for Aortic Arch Pathologies

Staged Fenestrated/Branched Repair of Postdissecting Thoracoabdominal Aneurysm With Candy-Plug False Lumen Occlusion for Spinal Cord Preconditioning

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