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Related Experiment Videos

Inducing false lumen thrombosis for retrograde type A aortic dissection.

Rongjie Zhang1, Jian Zhou1, Jiaxuan Feng1

  • 1Department of Vascular Surgery, Changhai Hospital, Second Military Medical University, Shanghai, China.

The Journal of Thoracic and Cardiovascular Surgery
|October 19, 2016
PubMed
Summary

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Inducing thrombosis in the false lumen of the aorta enhances the landing zone for thoracic endovascular aortic repair (TEVAR) in retrograde type A aortic dissection. This two-stage approach proved safe and effective in a small patient cohort.

Area of Science:

  • Cardiovascular Surgery
  • Endovascular Interventions
  • Aortic Dissection

Background:

  • Choosing a proximal landing zone for endovascular repair in retrograde type A aortic dissection with a patent false lumen is challenging.
  • This study addresses the need for improved strategies in managing complex aortic dissections.

Purpose of the Study:

  • To evaluate the safety and efficacy of inducing thrombosis in the retrograde false lumen to create a suitable proximal landing zone.
  • To assess the feasibility of a two-stage treatment approach for retrograde type A aortic dissection.

Main Methods:

  • A two-stage strategy was employed in 9 patients with retrograde type A aortic dissection.
  • Stage 1 involved embolization of the retrograde false lumen in the ascending aorta and aortic arch using coils and Onyx glue.
Keywords:
TEVARaortic dissectioncoilonyx glueretrograde

Related Experiment Videos

  • Stage 2 consisted of thoracic endovascular aortic repair (TEVAR) using the chimney technique.

    • Main Results:

    • Complete thrombosis of the retrograde false lumen was achieved in all 9 patients prior to TEVAR.
    • TEVAR success rate was 100%, with chimney techniques used for supra-aortic artery revascularization.
    • No in-hospital or 12-month follow-up morbidities, mortality, or new dissections were reported; positive remodeling was observed.

    Conclusions:

    • Inducing false lumen thrombosis is a safe and effective method for creating a proximal landing zone in retrograde type A aortic dissection.
    • The described two-stage approach offers satisfactory short-term outcomes for this complex aortic pathology.