Technique-Based Evaluation of Clinical Outcomes and Aortic Remodelling Following TEVAR in Acute and Subacute Type B Aortic Dissection

Zhong, Jim; Osman, Ahmed; Tingerides, Constantinos; Puppala, Sapna; Shaw, David R.; McPherson, Simon; Darwood, R.J.; Walker, Peter G.

doi:10.1007/s00270-020-02749-2

Cited by 12 publications

(16 citation statements)

References 37 publications

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“…Of course, the risk for aortic rupture during moulding is real, as described by Zhong et al. However, this, to the best of my knowledge, is the only published case of rupture so far [5].…”

mentioning

confidence: 77%

“…There was no problem to cannulate visceral vessels in the case of visceral vessels take off from the false lumen when applied this technique, and all the visceral artery stents were patent during follow-up. In contrast, TEVAR alone achieved complete thoracic aortic remodelling in 85% patients and but abdominal aortic remodelling (complete or partial) occurred in only 50% patients [5]. Similarly, Faure et al describe the results of the STABILISE technique in 41 patients with a 100% technical success, no aortic rupture and complete aortic remodelling in all cases [6] in the mid-term follow-up.…”

mentioning

confidence: 99%

“…In their paper ''Technique-based evaluation of clinical outcomes and aortic remodelling following TEVAR in acute and subacute type B aortic dissection'' published in this issue of CVIR, Zhong and colleagues present the results of 29 patients with acute (72%) and subacute (28%) complicated type B aortic dissection treated with TEVAR, PETTICOAT and STABILISE techniques [5]. The technical success was 100%.…”

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confidence: 99%

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STABILISE: The Way to Go in Treatment of Complicated Aortic Type-B Dissections?

Duvnjak

2021

Cardiovasc Intervent Radiol

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“…Of course, the risk for aortic rupture during moulding is real, as described by Zhong et al. However, this, to the best of my knowledge, is the only published case of rupture so far [5].…”

mentioning

confidence: 77%

mentioning

confidence: 99%

mentioning

confidence: 99%

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STABILISE: The Way to Go in Treatment of Complicated Aortic Type-B Dissections?

Duvnjak

2021

Cardiovasc Intervent Radiol

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“…Zhong et al [ 35 ] reported that complete remodeling after retrograde TEVAR in the proximal descending aorta, distal thoracic aorta, and infra-renal abdominal aorta occurred in 89%, 78%, and 50% of cases, respectively, during 31 months of follow-up. STABILISE is another technique to optimize the chances of abdominal remodeling by disrupting the FL and converting the aortic lumen into a single lumen.…”

Section: Impact Of Thoracic Endovascular Aortic Repair On Aortic Remodelingmentioning

confidence: 99%

“…The most widely used hybrid endovascular prostheses are the Thora flex hybrid (Terumo Aortic, Sunrise, FL, USA) and the E-vita Open (JOTEC GmbH, Hechingen, Germany) [ 41 ]. Multiple reports have suggested that FET open stenting is far better than the conventional ET, and it is the preferred modality to manage complex DeBakey type I AD and aneurysms [ 3 , 5 , 35 ]. The conventional ET group had higher mortality, while the FET group had a higher frequency of complete remodeling (FL thrombosis rate, 64% versus 29%) and fewer distal aortic re-interventions [ 50 ].…”

Section: Predictors Of Distal Aortic Remodelingmentioning

confidence: 99%

Distal Aortic Remodeling after Type A Dissection Repair: An Ongoing Mirage

Rathore

2021

J Chest Surg

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Remodeling is a commonly encountered term in the field of cardiothoracic surgery that is often used to describe various pathophysiological changes in the dimension, structure, and function of various cardiac chambers, including the aorta. Stanford type A or DeBakey type 1 aortic dissection (TAAD) is a perplexing pathologic condition that can present surgical teams with the need to navigate a maze of complex decision-making. Ascending or hemi-arch replacement leaves behind a significant amount of distal diseased aortic tissue, which might have a persistent false lumen or primary or secondary intimal tears (or communications between lumina), which can lead to dilatation of the aortic arch. Unfavorable aortic remodeling is a major cause of distal aortic deterioration after the index surgery. Cardiac surgeons are aware of post-surgical cardiac chamber remodeling, but the concept of distal aortic remodeling is still idealized. The contemporary literature from established aortic centers supports aggressive management of the residual aortic pathology during the index surgery, and with continuing technical advancements, endovascular stenting options are readily available for patients with TAAD or for complicated type B aortic dissection cases. This review discusses the pathophysiology and treatment options for favorable distal aortic remodeling, as well as its impact on mid-to long-term outcomes following TAAD repair.

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Aortic arch surgery for type B aortic dissection: How far should we go? The value of a hybrid approach

Capoccia

Sherif

Nassef

et al. 2023

Clinical Case Reports

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Traditionally, the management of type B aortic dissection has been the domain of the vascular surgeons. Timing and type of intervention still generate debate. We sought to review our early experience with the treatment of this condition based on a hybrid approach following an aortic multi‐disciplinary team meeting involving close cooperation between cardiac surgeons, vascular surgeons, interventional radiologists, vascular anesthetists, and cardiac anesthetists. Four patients (age 41–56 years; 3 males; 1 female) with type B aortic dissection underwent aortic arch surgery through a hybrid approach: one elective procedure consisting of ascending aorta and hemi‐arch replacement with debranching followed by thoracic endovascular aortic repair (TEVAR); one redo procedure requiring aortic arch replacement with hybrid frozen elephant trunk; two acute presentations (aortic arch replacement and debranching followed by TEVAR; AVR with ascending aorta, arch, and proximal descending thoracic aorta replacement with conventional elephant trunk and debranching). Deep hypothermic circulatory arrest was required in three patients. Despite respiratory complications and slightly prolonged postoperative course, all patients survived without onset of stroke, paraplegia, malperfusion, endoleak, or need for re‐exploration. Follow‐up remains satisfactory. Different factors may affect outcome following complex aortic procedures. Nevertheless, close cooperation between cardiac surgeons, vascular surgeons, and interventional radiologists may reduce potential for complications and address aspects that may not be completely within the domain of individual specialists.

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Technique-Based Evaluation of Clinical Outcomes and Aortic Remodelling Following TEVAR in Acute and Subacute Type B Aortic Dissection

Cited by 12 publications

References 37 publications

STABILISE: The Way to Go in Treatment of Complicated Aortic Type-B Dissections?

STABILISE: The Way to Go in Treatment of Complicated Aortic Type-B Dissections?

Distal Aortic Remodeling after Type A Dissection Repair: An Ongoing Mirage

Aortic arch surgery for type B aortic dissection: How far should we go? The value of a hybrid approach

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