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Intentional Targeted False Lumen Occlusion after Aortic Dissection: A Systematic Review of the Literature

Konstantinos Spanos1, Tilo Kölbel1, Fiona Rohlffs1

  • 1German Aortic Center, Department of Vascular Medicine, University Heart Center, Hamburg, Germany.

Annals of Vascular Surgery
|November 30, 2018
PubMed

Insights

Targeted false lumen (FL) thrombosis is a feasible endovascular technique for patients with chronic type B aortic dissection (cTBAD) or type A aortic dissection (TAAD). This approach shows promising results in achieving FL occlusion and may improve long-term outcomes.

Area of Science:

  • Cardiovascular Surgery
  • Endovascular Techniques
  • Aortic Dissection Management

Background:

  • Residual patent false lumen (FL) after aortic dissection treatment is linked to adverse long-term outcomes.
  • Chronic type B aortic dissection (cTBAD) and type A aortic dissection (TAAD) are significant cardiovascular conditions.
  • Effective management of residual FL is crucial for improving patient prognosis.

Purpose of the Study:

  • To review endovascular techniques for targeted false lumen (FL) thrombosis.
  • To present existing clinical experience with FL occlusion after cTBAD and TAAD.
  • To evaluate the feasibility and outcomes of intentional FL occlusion.

Main Methods:

  • Systematic review adhering to Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines.
  • Searched MEDLINE, CENTRAL, and Cochrane databases for relevant studies.
  • Included studies reporting on targeted FL occlusion following cTBAD or TAAD treatment.

Main Results:

  • One hundred one patients (40 TAAD, 61 cTBAD) underwent intentional FL occlusion.
  • Technical success rate was 100% with low 30-day mortality (2.5% TAAD, 0% cTBAD).
  • Complete FL thrombosis achieved in 78% of TAAD and 62% of cTBAD patients at follow-up (2-63 months).

Conclusions:

  • Intentional FL occlusion is a feasible, less invasive approach for managing residual FL post-aortic dissection repair.
  • The technique is currently underutilized.
  • Larger studies with extended follow-up are needed to confirm benefits in aortic remodeling and disease stabilization.
Abstract

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