Stent-assisted balloon dilatation of chronic aortic dissection

Type B Aortic Dissection Treated with a Branched Aortic Arch Stent Graft and the STABILISE Technique Simple Abstract

“…Fenestrated and branched stent grafts in the aortic arch have been used in some expert centers to treat post dissection arch aneurysms, with an in hospital death rate of 5.3%; possible complications include early type 1 endoleak (5.3%) and cerebrovascular events (10.5%), with the absence of late aorta-related mortality [3]. The Stabilise technique allows aortic remodeling in cases of acute and chronic type B dissection while not compromising the patency of collateral branches arising from the true lumen [4,5]. This novel combined technique seems to provide a proximal seal zone and allow both thrombosis of the thoracic aortic false lumen and remodeling of the distal aorta in patients with type B aortic dissection without a proximal neck.…”

“…Branched arch grafts have shown promising results [3]. The stent-assisted balloon induced intimal disruption and delamination (Stabilise) technique has also shown good results in the treatment of acute and chronic aortic dissection [4,5]. Here, we report a combined treatment for type B aortic dissection consisting of a branched aortic arch graft and the STABILISE technique.…”

Commentary: Cracking the code for chronic aortic dissection

“…Nonetheless, there was no further aortic growth documented in any patients and descending thoracic aortic shrinkage was present in all. 7 This procedure is promising because the achievement of false lumen thrombosis in combination with aortic shrinkage is most consistent with prolonged survival, as has been demonstrated by Mani and colleagues. 8 The promising findings of this early study 7 support the need for further exploration of adjunctive techniques to promote positive aortic remodeling and more proactively address the false lumen.…”

“…Different from what we described, the procedures performed by Faure and colleagues 7 included bare metal stent coverage across the visceral segment and into the infrarenal aorta, and the ballooning was performed through the entire length of the thoracoabdominal aorta. Additional stenting was performed into branch vessels that were involved with dissection or whose orifice originated from the false lumen (10 renal arteries), and more than half of the patients had additional stenting of both common iliac arteries.…”

“…4,5 The stentassisted balloon-induced intimal disruption and relamination of aortic dissection technique has been described as an adjunct to thoracic endovascular aortic repair during the acute phase. 6 Now, Faure and colleagues 7 have described their experience using a similar adjunctive technique of stent-assisted balloon dilatation of the dissection flap in the chronic phase of disease. This is an early experience, with their first 17 patients treated beginning in 2015 with median follow-up of 17 months (range, 3-28.5 months).…”