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Clinical Utility of the Candy-Plug Technique Using an Excluder Aortic Extender.

Yukihisa Ogawa1, Hiroshi Nishimaki2, Kiyoshi Chiba2

  • 1Department of Radiology, St. Marianna University, School of Medicine, Kawasaki, Kanagawa, Japan.

Annals of Vascular Diseases
|July 9, 2021
PubMed
Summary

The candy-plug technique with an Excluder aortic extender (Ex-cuff) shows promise for false lumen (FL) occlusion in chronic aortic dissection. While technically feasible, complete embolization may require additional materials, especially in rupture cases.

Keywords:
Excluder aortic extenderaortic dissectioncandy-plug techniquerupturethoracic endovascular aortic repair

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Area of Science:

  • Vascular Surgery
  • Endovascular Repair
  • Aortic Dissection Management

Background:

  • Chronic aortic dissection can lead to aneurysmal dilatation or rupture.
  • False lumen (FL) management is crucial in thoracic endovascular aortic repair (TEVAR).

Purpose of the Study:

  • To evaluate the clinical utility and technical aspects of the candy-plug technique with an Excluder aortic extender (Ex-cuff).
  • To assess FL occlusion in patients with chronic aortic dissection undergoing TEVAR.

Main Methods:

  • Retrospective analysis of seven patients undergoing TEVAR with the candy-plug technique for FL occlusion.
  • Assessment of technical success (deployment accuracy) and clinical success (no FL backflow on CT angiography).

Main Results:

  • Technical success was achieved in 86% of patients; failure was due to device malposition.
  • Clinical success was observed in 57% of patients, with incomplete embolization in two.
  • No FL enlargement occurred during a mean follow-up of 593 days; all patients survived.

Conclusions:

  • The candy-plug technique using an Ex-cuff is a feasible option for FL occlusion in chronic aortic dissection.
  • Complete Amplatzer Vascular Plug (AVP) embolization may be delayed, suggesting the need for additional embolic materials.
  • Consideration of adjunctive embolic materials is recommended for rupture cases.