Related Experiment Video
Updated: Jul 15, 2026
Novel and Innovative Hybrid Technique for Type A Aortic Dissection
Published on: March 28, 2025
[Endovascular stent-graft treatment for DeBakey I aortic dissection]
Guang-qi Chang1, Shen-ming Wang, Xiao-xi Li
1Department of Vascular Surgery, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China.
Insights
Endovascular repair is a feasible and effective treatment for DeBakey type I aortic dissection. This minimally invasive approach shows promising results in managing this complex aortic condition.
Area of Science:
- Cardiovascular Surgery
- Vascular Endovascular Therapy
- Aortic Aneurysm Research
Context:
- DeBakey type I aortic dissection presents significant surgical challenges.
- Traditional open repair carries high morbidity and mortality.
- Minimally invasive endovascular techniques offer an alternative for aortic dissection management.
Purpose:
- To evaluate the feasibility and efficacy of endovascular stent-graft treatment for DeBakey type I aortic dissection.
- To assess the outcomes and safety of this minimally invasive approach.
Summary:
- Seven patients with DeBakey type I aortic dissection underwent endovascular repair using stent-grafts.
- Treatments were delivered via left common carotid artery or right femoral artery approaches.
- 100% operative success was achieved, with persistent endoleaks resolved by secondary stent placement. False lumen thrombosis was observed in all treated cases.
Impact:
- Endovascular treatment is a viable, minimally invasive option for DeBakey type I aortic dissection.
- Successful outcomes depend on careful patient selection, particularly regarding the proximity of coronary artery ostia to the intimal tear.
- This approach may reduce surgical risks compared to open repair.
Objective:
To study endovascular treatment of DeBakey type I aortic dissecting aneurysm.
Methods:
Seven patients with DeBakey I aortic dissecting aneurysms were treated. Diagnoses were confirmed by MRA, CT and angiography. The intimal tear entry was in the ascending aorta, 2.5 approximately 6.0 cm from the ostia of the coronary arteries, and 0.5 approximately 4.0 cm from the brachiocephalic trunk opening. Endovascular stent-grafts were deployed via a left common carotid artery (LCCA) approach in 2 cases and right femoral artery (RFA) approach in 5 cases. Prior to treatment, a left subclavicular artery (LSA)-LCCA shunt was established to ensure blood supply to the LCCA during surgery in 2 cases via LCCA approach, and a LSA-LCCA-right common carotid artery (RCCA) synthetic bypass was established to ensure blood supply to the brain in 2 cases in RFA approach.
Results:
The operative success rate was 100%. In 3 cases, endoleak persisted after the first stent was placed, but this was eliminated by placement of a second stent. All patients survived except one who died of acute massive hemorrhage from the upper gastrointestinal tract one month postoperatively. The false lumen in all 6 cases became thrombosed and no endoleak or new aortic dissecting aneurysms developed.
Conclusions:
Endovascular treatment of DeBakey type I aortic dissecting aneurysm is feasible, minimally invasive, and effective. Case selection depends on the distance of the coronary artery ostia from the tear entry.
