Initial Study of the Extended STABILISE Technique for Complete Remodeling in Aortic Dissection

Area of Science:

• Vascular Surgery
• Cardiovascular Interventions
• Aortic Disease Management

Background:

• Thoracic endovascular aortic repair (TEVAR) is standard for acute complicated type B aortic dissection (TBAD).
• TEVAR often results in incomplete aortic remodeling and risks aneurysmal degeneration.
• Distal re-entry and aortoiliac bifurcation treatment are crucial for complete TBAD remodeling and limb perfusion.

Purpose of the Study:

• To evaluate the safety and efficacy of the extended STABILISE (e-STABILISE) technique for treating complicated TBAD.
• To assess the need for aortoiliac bifurcation treatment in specific TBAD cases.
• To determine the impact of e-STABILISE on aortic remodeling and true lumen expansion.

Main Methods:

• Eleven patients with acute/sub-acute complicated TBAD or non-A non-B aortic dissection underwent endovascular repair.
• The stent-assisted, balloon-induced intimal disruption and relamination in aortic dissection repair (STABILISE) technique was applied.
• Two patients required additional treatment of the aortoiliac bifurcation using a bifurcated AFX endograft for limb ischemia due to true lumen collapse.

Main Results:

• All procedures achieved technical success with no procedural complications.
• No postoperative mortality, stroke, paraplegia, or visceral ischemia occurred.
• Satisfactory aortic remodeling was observed, with a mean 57.5% true lumen expansion during follow-up.

Conclusions:

• The initial e-STABILISE technique using a bifurcated AFX endograft demonstrated no postoperative mortality or complications.
• This technique is currently best reserved for select patients requiring revascularization of the aortoiliac bifurcation.
• Further data is needed to fully establish the role of e-STABILISE in TBAD management.