The first endovascular repair of an acute type A dissection using an endograft designed for the ascending aorta

Abstract

Endovascular repair has emerged as a potential alternative to emergency open surgical repair for type A dissection in selected patients, with isolated reports describing the results obtained with a range of devices designed originally for the descending aorta. We believe that we present the first reported repair of an acute ascending aortic dissection using an endovascular stent graft manufactured specifically for the ascending aorta.

Endovascular repair of the ascending aorta in patients at high risk for open repair

“…Other aortic centers of excellence have also reported small series of endovascular repair of the ascending aorta with similar results. [1][2][3][4][5][6][7][8][9][10][11][12][13][14] Generally, worldwide experience has been limited by multiple factors, including anatomic constraints of the proximal aorta, the lack of devices specifically designed for the ascending aorta, and the lack of disease-specific stent-graft technologies.…”

Midterm Results of Endovascular Stent Grafts in the Proximal Aortic Arch (Zone 0): An Imaging Perspective

“…Potential adverse outcomes include endoleak development, device fracture and device migration, 21 A totally endovascular Zone 0 approach is already being used in repair of acute type A dissection in patients who are not surgical candidates. 25 26 27 28 29 A recent publication 30 on the use of a hybrid room to diagnose and manage acute Type A dissections reveals that up to 25% of patients have some form of visceral and peripheral malperfusion. These cases may benefit from endovascular options to obliterate the primary intimal tear across the arch and proximal descending aorta.…”

Computed Tomography-Based Study Exploring the Feasibility of Endovascular Treatment of Type A Aortic Dissection in the Chinese Population

“…A new device designed specifically for the ascending aorta (Cook's Zenith TX2 low profile) and soon to be released can reduce these difficulties for the surgeon. 23 …”