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Endovascular Repair in Acute Complicated Type B Aortic Dissection: 3-Year Results from the Valiant US Investigational
1Department of Thoracic and Cardiovascular Surgery, Andong General Hospital.
Insights
Acute complicated type B aortic dissection (TBAD) is a serious condition. The Valiant Captivia Thoracic Stent Graft offers a safe and effective endovascular repair option, showing promising 3-year survival rates.
Area of Science:
- Cardiovascular Surgery
- Vascular Endovascular Therapy
- Thoracic Aortic Disease
Background:
- Acute complicated type B aortic dissection (TBAD) is a life-threatening condition with high risks of rupture, organ damage, or death.
- Refractory hypertension and age are key risk factors for TBAD.
- Endovascular repair has become the preferred treatment for TBAD due to superior outcomes compared to open repair and medical therapy.
Purpose of the Study:
- To review the Valiant Captivia Thoracic Stent Graft System, a third-generation endovascular device.
- To present the 3-year outcomes of patients treated with the Valiant Captivia Stent Graft for acute complicated TBAD.
Main Methods:
- Review of the Valiant Captivia Thoracic Stent Graft System's features, including minimally invasive delivery and anatomical conformability.
- Presentation of 3-year follow-up data for patients with acute complicated TBAD treated with the stent graft.
Main Results:
- Freedom from all-cause mortality was 79.1% at 3 years.
- Freedom from dissection-related mortality was 90.0% at 3 years.
- The Valiant Captivia Stent Graft demonstrated effectiveness in mitigating adverse sequelae.
Conclusions:
- The Valiant Captivia Stent Graft is a safe and effective intervention for acute complicated type B aortic dissection.
- Longer-term surveillance is necessary to confirm the durability of the stent graft.
- Continued innovation in stent graft technology is crucial for improving outcomes in TBAD treatment.
Abstract:
Acute complicated type B aortic dissection (TBAD) is a potentially catastrophic, life-threatening condition. If left untreated, there is a high risk of aortic rupture, irreversible organ or limb damage, or death. Several risk factors have been associated with acute complicated TBAD, including age and refractory hypertension. In the acute phase, even uncomplicated patients are more prone to develop complications if hypertension and pain are left medically untreated. Innovations in stent graft technologies have incrementally improved outcomes since their first use for this condition in 1999, though improvement is needed in mitigating periprocedural complications, adverse events, and mortality. In the past decade, endovascular repair has become the preferred treatment because of its superior outcomes to open repair and medical therapy. The Valiant Captivia Thoracic Stent Graft System is a third-generation endovascular stent graft with advancements in minimally invasive delivery, conformability to the anatomy, and the minimization of adverse sequelae. Herein, this stent graft is briefly reviewed and its 3-year outcomes are presented. Freedom from all-cause and dissection-related mortality was 79.1% and 90.0%, respectively. The Valiant Captivia Stent Graft represents a safe, effective intervention for acute complicated TBAD. Continued surveillance is needed to verify its longer-term durability.
