Novel Percutaneous Treatment of Cerebral Malperfusion Before Surgery for Acute Type A Dissection

Immediate Surgery in Acute Type A Dissection and Neurologic Dysfunction: Fighting the Inevitable?

“…3,11,12 These optimal data most likely reflect that independently of therapeutic improvements or implementation of cerebral protection techniques, neurologic injury remains an important but supposedly inevitable complication when performing surgical repair in AAD. Based on our data and promising case report by Heran and colleagues, 19 one might raise the question whether cerebral reperfusion by percutaneous vascular interventions should be performed as a bailout procedure before surgical aortic repair in patients with PND and impaired cerebral perfusion.…”

Preoperative percutaneous carotid artery recanalization in a patient with aortic dissection type A

“…However, endovascular carotid recanalization in the setting of ATAAD is still being reported only anecdotally. Heran et al recently presented the case of an ATAAD patient with right CCA occlusion who underwent successful percutaneous carotid stenting before surgical repair with excellent neurological outcome 4 . However, to the authors' knowledge, the here presented case is the first report regarding successful percutaneous recanalization of an ICA occlusion in the setting of an ATAAD before open surgical aortic repair with excellent clinical outcome after three year follow‐up, including almost full neurological recovery.…”

Type A Acute Aortic Dissection Presenting With Cerebrovascular Accident at Advanced Age

“…Other groups have reported direct surgical fenestration of the carotid artery, intra-operative carotid stenting, and percutaneous carotid stenting before the initiation of surgical repair, with favorable neurological outcomes. [26][27][28][29][30] The role of cerebral perfusion during HCA has been extensively discussed. In the present analysis, cerebral perfusion was utilized more commonly in patients presenting with CVA (94.9% versus 81.8%, p = 0.036) (Supplementary Table 2).…”