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Updated: Jul 12, 2025
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Novel and Innovative Hybrid Technique for Type A Aortic Dissection
Published on: March 28, 2025
320
Thoracic Endovascular Repair after Total Aortic Arch Replacement with Frozen Elephant Trunk for Type a Aortic
William Fortin1, Charles-Henri Gautier2, Remi Escande2
1Department of Vascular Surgery, Hôpital du Sacré-Cœur de Montréal, Montreal, Canada; Department of Medicine, University of Montreal, Montreal, Canada.
Annals of Vascular Surgery
|October 20, 2023
Summary
Second-stage endovascular repair effectively manages residual aortic dissection after Frozen elephant trunk repair, showing excellent outcomes and significant aortic remodeling. The STABILISE technique demonstrated superior results in this patient cohort.
Area of Science:
- Cardiovascular Surgery
- Endovascular Interventions
- Aortic Disease Management
Background:
- Management of residual aortic dissection post-Type A repair with Frozen elephant trunk (FET) is not well-established.
- This study evaluates the efficacy of second-stage endovascular surgery for residual aortic dissection.
Purpose of the Study:
- To assess the outcomes of endovascular second-stage surgery for residual aortic dissection after FET repair.
- To evaluate aortic remodeling and perioperative complications in these patients.
Main Methods:
- Retrospective analysis of 34 patients undergoing Type A repair with FET followed by second-stage endovascular procedures (March 2016-December 2021).
- Primary outcome: aortic-related adverse events or mortality. Secondary outcomes: aortic remodeling and perioperative complications.
- Aortic remodeling assessed by true lumen/total aortic diameter ratios pre- and post-procedure.
Main Results:
- No perioperative deaths or major complications; one reoperation for re-embolization.
- No aortic-related mortality at median 23-month follow-up; 5 aortic-related adverse events occurred.
- Significant distal aortic remodeling observed (P < 0.01), particularly with the STABILISE technique.
Conclusions:
- Second-stage endovascular management of residual aortic dissection after FET repair offers excellent perioperative and good midterm outcomes.
- Significant aortic remodeling was achieved, especially with the STABILISE procedure.
- Connective tissue disorders and large aneurysms (>55 mm) were risk factors for adverse events.
