Renal Sympathetic Denervation in Patients with Aortic Dissection

Divchev, Dimitar; Turan, Gökmen; Rehders, Tim C.; Nienaber, Christoph

doi:10.1111/joic.12110

Cited by 5 publications

(3 citation statements)

References 22 publications

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“…Thus, with better understanding of adverse predictors, the concept of pre-emptive repair of any type B aortic dissection by endovascular interventions should be considered for all patients with type B dissection regardless of presenting symptoms and in addition to life-long pharmaceutical blood pressure control as long as they are anatomically suitable. All patients should be followed and offered sustained surveillance with focus on blood pressure control and progressive expansion; even renal sympathetic denervation may have a role [ 39 ]. With this novel approach, chances are that thoraco-abdominal aneurysmatic expansion of dissected aortas could be prevented in the future.…”

Section: Discussionmentioning

confidence: 98%

Acute Aortic Syndrome: Medical Management

Nienaber

2014

Pharmacotherapy in Aortic Disease

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Section: Discussionmentioning

confidence: 98%

Acute Aortic Syndrome: Medical Management

Nienaber

2014

Pharmacotherapy in Aortic Disease

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“…Therefore, regardless of presenting symptoms and in the light of better understanding of adverse predictors, the concept of pre-emptive repair of type B dissection with single and/or large entry tears10 by endovascular interventions needs to be discussed with any given patient and should be offered at very low procedural risk; life-time surveillance and strict blood pressure management, even including sympathetic renal denervation, appear warranted 30. With this novel approach, chances are that thoracoabdominal aneurysmatic expansion of dissected aortas are prevented and such extremely challenging cases are less frequent in the future 31.…”

Section: Discussion and Outlookmentioning

confidence: 99%

Early and late management of type B aortic dissection

Nienaber

Divchev

Palisch

et al. 2014

Heart

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The management of type B aortic dissection is undergoing profound changes with timely TEVAR accepted as first-line strategy in the setting of complicated dissection; with recent technological advances and in experienced hands this intervention is considered safe and life-saving. With the ability to remodel the dissected aorta as a result of scaffolding even pre-emptive endovascular treatment is being considered and supported by long-term stability and often prevention of aneurysmal expansion. This insight and a growing number of silent risk conditions (resistant hypertension, partial false lumen thrombosis) may lower the threshold for TEVAR in asymptomatic patients in the subacute phase. In the chronic phase of a type B dissection patients are usually free of symptoms, however, with the expanding false lumen at risk of rupture. Advanced TEVAR options (including branches and fenestrations) are likely to be used more often than open surgical replacement of such aneurysmatic segment of the dissected aorta in that chronic phase. All dissection patients should be offered lifelong surveillance.

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“…Hypertension is a common finding in the post-intervention period in patients with acute AD, and is a predictor of late complications [76]. Recent trials investigating renal sympathetic denervation in hypertensive patients after endovascular therapy for AD achieved significant and sustained reductions in systolic and diastolic blood pressure without significant complications [77].…”

Section: Thoracic Endovascular Aortic Repairmentioning

confidence: 99%

A Contemporary Review of Acute Aortic Dissection

LN¹,

C²,

RV³

2015

Emerg Med (Los Angel)

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Acute aortic dissection is one of the most rapidly fatal clinical entities that can be encountered in the emergency department setting. Prompt establishment of the diagnosis, through focused physical examination and non-invasive imaging, followed by rapid medical and surgical therapy, are the only effective methods to alter survival in patients with acute aortic dissection. The aim of this paper is to perform an up-to-date clinical review of acute aortic dissection including its epidemiology, risk factors, clinical presentation, algorithms in establishing the diagnosis, and of available medical and surgical therapies.

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Renal Sympathetic Denervation in Patients with Aortic Dissection

Abstract: RSD using the Symplicity® catheter system is feasible and safe in hypertensive patients previously subjected to endovascular repair for complicated aortic dissection.

Cited by 5 publications

References 22 publications

Acute Aortic Syndrome: Medical Management

Acute Aortic Syndrome: Medical Management

Early and late management of type B aortic dissection

A Contemporary Review of Acute Aortic Dissection

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