The Number of Preoperative Abdominal False Lumen–perfused Small Branches Is Related to Abdominal Aortic Remodeling after Thoracic Endovascular Aortic Repair for Type B Aortic Dissection

Ge, Yangyang; Lv, Xiaomeng; Ge, Xiaohu; Fan, Weidong; Rong, Dan; Guo, Wei

doi:10.1016/j.avsg.2020.09.007

Cited by 4 publications

(1 citation statement)

References 15 publications

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“…We did not have data on the number of small branches that may have played a role in the FL thrombosis. 26 A multicentric larger cohort with a longer follow-up is warranted to confirm our single-center experience of CP technique and its effect on aortic remodeling in chronic AD.…”

Section: Discussionmentioning

confidence: 82%

Aortic Remodeling After Custom-Made Candy-Plug for Distal False Lumen Occlusion in Aortic Dissection

Eleshra¹,

Rohlffs²,

Σπανός³

et al. 2021

J Endovasc Ther

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Purpose: To report a single-center experience with the use of a custom-made Candy-Plug (CP) for distal false-lumen (FL) occlusion in subacute and chronic aortic dissection (AD). Materials and Methods: A retrospective single-center analysis was conducted on consecutive patients with subacute and chronic AD who were treated with a custom-made CP for distal FL occlusion using 3 design generations (CP I to CP III) from October 2013 to September 2019. Results: A custom-made CP was used in 57 patients. Of these, 34 patients (29 males, mean age 62±10 years) were treated with a CP I vs 23 patients (16 males, mean age 59±17 years) with CP II/III. Technical success was achieved in 57 (100%) patients. Clinical success was achieved in 54 (95%) patients; 33 (97%) in CP I group vs 21 (91%) patients in CP II/III group, p=0.116. The mean hospital stay was 10±8 days (9±5 days in CP I group vs 13±9 days in CP II/III, p=0.102). The 30-day computed tomography angiography (CTA) confirmed successful CP placement at the intended level in all patients within both groups. Early complete FL occlusion was achieved in 50 (88%) patients; 30 (88%) patients in CP I group vs 20 (87%) in CP II/III group, p=0.894. Follow up CTA was available in 44 (77%) patients. Of these; 30/34 (88%) patients in CP I group with mean follow-up 29±17 months) vs. 14/23 (61%) patients with mean follow-up 14±5 months in CP II/III group. Thoracic aortic remodeling was achieved in 34/44 (77%) patients; 25/30 (83%) patients in CP I group vs 9/14 (64%) patients in CP II/III group, p=0.197. The aneurysm size remained stable in 9/44 (20%) patients; 5/30 (17%) patients in CP I group vs 4/14 (29%) patients in CP II/III group, p=0.741. The thoracic aneurysm increased size was seen in 1/44 (2%) patient. This patient was in CPII/III group. Conclusion: CP technique using custom-made devices is technically feasible with a low mortality and morbidity, and a high rate of aortic remodeling. Both, the original design (CP I) and newer designs with a self-closing central sleeve (CP II and CP III) showed similar excellent outcomes.

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Section: Discussionmentioning

confidence: 82%

Aortic Remodeling After Custom-Made Candy-Plug for Distal False Lumen Occlusion in Aortic Dissection

Eleshra¹,

Rohlffs²,

Σπανός³

et al. 2021

J Endovasc Ther

View full text Add to dashboard Cite

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Custom Made Candy Plug for Distal False Lumen Occlusion in Aortic Dissection: International Experience

Eleshra

Haulon

Bertoglio

et al. 2023

European Journal of Vascular and Endovascular Surgery

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Deep Learning Prediction for Distal Aortic Remodeling After Thoracic Endovascular Aortic Repair in Stanford Type B Aortic Dissection

et al. 2023

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Purpose: This study aimed to develop a deep learning model for predicting distal aortic remodeling after proximal thoracic endovascular aortic repair (TEVAR) in patients with Stanford type B aortic dissection (TBAD) using computed tomography angiography (CTA). Methods: A total of 147 patients with acute or subacute TBAD who underwent proximal TEVAR at a single center were retrospectively reviewed. The boundary of aorta was manually segmented, and the point clouds of each aorta were obtained. Prediction of negative aortic remodeling or reintervention was accomplished by a convolutional neural network (CNN) and a point cloud neural network (PC-NN), respectively. The discriminatory value of the established models was mainly evaluated by the area under the receiver operating characteristic curve (AUC) in the test set. Results: The mean follow-up time was 34.0 months (range: 12–108 months). During follow-up, a total of 25 (17.0%) patients were identified as having negative aortic remodeling, and 16 (10.9%) patients received reintervention. The AUC (0.876) by PC-NN for predicting negative aortic remodeling was superior to that obtained by CNN (0.612, p=0.034) and similar to the AUC by PC-NN combined with clinical features (0.884, p=0.92). As to reintervention, the AUC by PC-NN was significantly higher than that by CNN (0.805 vs 0.579; p=0.042), and AUCs by PC-NN combined with clinical features and PC-NN alone were comparable (0.836 vs 0.805; p=0.81). Conclusion: The CTA-based deep learning algorithms may assist clinicians in automated prediction of distal aortic remodeling after TEVAR for acute or subacute TBAD. Clinical Impact: Negative aortic remodeling is the leading cause of late reintervention after proximal thoracic endovascular aortic repair (TEVAR) for Stanford type B aortic dissection (TBAD), and possesses great challenge to endovascular repair. Early recognizing high-risk patients is of supreme importance for optimizing the follow-up interval and therapy strategy. Currently, clinicians predict the prognosis of these patients based on several imaging signs, which is subjective. The computed tomography angiography-based deep learning algorithms may incorporate abundant morphological information of aorta, provide with a definite and objective output value, and finally assist clinicians in automated prediction of distal aortic remodeling after TEVAR for acute or subacute TBAD.

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The Number of Preoperative Abdominal False Lumen–perfused Small Branches Is Related to Abdominal Aortic Remodeling after Thoracic Endovascular Aortic Repair for Type B Aortic Dissection

Cited by 4 publications

References 15 publications

Aortic Remodeling After Custom-Made Candy-Plug for Distal False Lumen Occlusion in Aortic Dissection

Aortic Remodeling After Custom-Made Candy-Plug for Distal False Lumen Occlusion in Aortic Dissection

Custom Made Candy Plug for Distal False Lumen Occlusion in Aortic Dissection: International Experience

Deep Learning Prediction for Distal Aortic Remodeling After Thoracic Endovascular Aortic Repair in Stanford Type B Aortic Dissection

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