Related Experiment Video
Updated: Aug 26, 2025
Novel and Innovative Hybrid Technique for Type A Aortic Dissection
Published on: March 28, 2025
Three-year outcomes of the Dissected Aorta Repair Through Stent Implantation trial
Sabin J Bozso1, Jeevan Nagendran1, Michael W A Chu2
1Division of Cardiac Surgery, University of Alberta, Edmonton, Canada.
Insights
The Ascyrus Medical Dissection Stent shows promise for treating acute DeBakey type I aortic dissection, promoting positive aortic remodeling. This technology aids in repairing the aortic arch and proximal descending aorta, with promising 3-year outcomes.
Area of Science:
- Cardiovascular Surgery
- Medical Devices
- Aortic Dissection
Background:
- Acute DeBakey type I aortic dissection is a life-threatening condition requiring complex surgical management.
- The Ascyrus Medical Dissection Stent (AMDS) offers a novel approach to managing these dissections, particularly involving the aortic arch.
Purpose of the Study:
- To evaluate the clinical and radiographic outcomes of the AMDS in patients with acute DeBakey type I aortic dissection.
- To assess the stent's efficacy in promoting positive aortic remodeling and its impact on patient survival and complications.
Main Methods:
- A prospective, nonrandomized, international study (Dissected Aorta Repair Through Stent Implantation) enrolled 47 patients.
- Patients with acute DeBakey type I aortic dissection were treated with AMDS combined with standard surgical repair, including hemiarch repair for most.
- Median follow-up was 3 years, with assessment of clinical and radiographic outcomes, including aortic diameter and false lumen thrombosis.
Main Results:
- Successful AMDS implantation was achieved in all patients undergoing emergency repair.
- At 3 years, overall mortality was 21.7%, and the new stroke rate was 15.2%.
- Significant positive aortic remodeling was observed, with decreased or stable aortic diameter in zones 0, 1, and 2, and substantial false lumen thrombosis (up to 90.5% in zone 0).
Conclusions:
- The AMDS is a promising, simple technology for treating acute DeBakey type I aortic dissection, facilitating repair of the aortic arch and proximal descending aorta.
- The stent promotes positive aortic remodeling and demonstrates encouraging mid-term results.
- Ongoing follow-up will provide further long-term data on the efficacy and safety of the AMDS.
Objective:
The study objective was to evaluate the clinical and radiographic outcomes of the Ascyrus Medical Dissection Stent in a prospective, nonrandomized, international study (Dissected Aorta Repair Through Stent Implantation) of patients with acute DeBakey type I aortic dissection.
Methods:
The Ascyrus Medical Dissection Stent was used in combination with the standard surgical management of acute DeBakey type I aortic dissection I to treat patients with (56.5%, 26/46) and without (43.5%, 20/46) preoperative clinical and radiographic malperfusion. All patients had a primary entry tear in the ascending aorta, and 97.8% (45/46) were treated with a hemiarch repair. Median follow-up was 3 years.
Results:
All 47 patients underwent emergency surgical repair with successful Ascyrus Medical Dissection Stent implantation. One patient was excluded from analysis due to use in iatrogenic dissection. Overall mortality at 30 days and 3 years was 13.0% (6/46) and 21.7% (10/46), respectively. Overall new stroke rate at 30 days was 15.2% (7/46). No devices were explanted at any time during the 3-year median follow-up. At 3 years, the total aortic diameter in zones 0, 1, and 2 decreased or remained stable in 91.7%, 72.7%, and 75.0%, respectively. The false lumen was completely or partially thrombosed in 90.5% in zone 0, 60.0% in zone 1, and 68.2% in zone 2 at 3 years.
Conclusions:
The use of the Ascyrus Medical Dissection Stent in the treatment of acute DeBakey type I aortic dissection I holds promise as a simple technology that enables repair of the aortic arch and proximal descending aorta, while promoting positive aortic remodeling. Ongoing follow-up of the Dissected Aorta Repair Through Stent Implantation trial will provide long-term, prospective, clinical outcomes and radiographic data on positive remodeling of the aortic arch.
