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Related Experiment Video

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Novel and Innovative Hybrid Technique for Type A Aortic Dissection
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Addressing persistent false lumen flow in chronic aortic dissection: the knickerbocker technique.

Tilo Kölbel1, Sebastian W Carpenter, Christina Lohrenz

  • 1University Heart Center, University Hospital Hamburg Eppendorf, Germany.

Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists
|February 8, 2014
PubMed
Summary

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The Knickerbocker technique successfully thromboses false lumen aneurysms in type B aortic dissection. This innovative method uses controlled membrane rupture after stent-grafting to prevent further false lumen perfusion.

Area of Science:

  • Vascular Surgery
  • Interventional Cardiology
  • Aortic Aneurysm Research

Background:

  • Chronic type B aortic dissection can lead to false lumen aneurysms.
  • These aneurysms pose a risk of rupture and require effective treatment.
  • Current stent-grafting techniques may not always occlude distal false lumen perfusion.

Observation:

  • The Knickerbocker technique involves relining the true lumen with an oversized thoracic endograft.
  • Controlled rupture of the dissection membrane is achieved using a large compliant balloon.
  • This expands the stent-graft into the false lumen, occluding distal entry tears.

Findings:

  • The technique was successfully applied in 3 patients with symptomatic false lumen aneurysms.
  • No short-term mortality was observed.

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  • Mean follow-up of 8 months showed persistent false lumen thrombosis.
  • Mean clinical follow-up of 22 months reported no mortality.

    • Implications:

    • The Knickerbocker technique is a feasible and effective option for selected patients.
    • It offers a novel approach to inducing false lumen thrombosis in chronic type B aortic dissection.
    • This method may improve outcomes for patients with complex aortic pathologies.