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A New Murine Model of Endovascular Aortic Aneurysm Repair
Published on: July 7, 2013
Efficacy of endovascular circulating false lumen occlusion in chronic aneurysmal descending aortic dissections
Emeric Gremen1,2, Mathieu Finas2, Eliott Mathieu2
1Grenoble-Alpes University Faculty of Medicine, Department of Radiology, Grenoble, France
Insights
Endovascular circulating false lumen occlusion (CFLO) effectively promotes false lumen thrombosis and positive aortic remodeling in chronic aneurysmal descending aortic dissection. This technique offers a valuable option for managing complex aortic pathologies.
Area of Science:
- Vascular Surgery
- Interventional Cardiology
- Aortic Disease Management
Background:
- Chronic aneurysmal descending aortic dissection (AD) presents a significant management challenge.
- Persistent circulating false lumen (FL) contributes to progressive aortic enlargement and adverse outcomes.
- Effective endovascular strategies are needed to improve aortic remodeling and reduce aneurysm progression.
Purpose of the Study:
- To evaluate the efficacy of endovascular circulating false lumen occlusion (CFLO) in inducing positive aortic remodeling.
- To assess the impact of CFLO on false lumen thrombosis and aortic diameter.
- To determine the safety and clinical outcomes of CFLO in chronic AD patients.
Main Methods:
- Retrospective monocentric study of patients with chronic AD and persistent circulating FL treated with CFLO.
- CFLO involved coils, plugs, glue, and/or covered stenting.
- Primary endpoint: positive aortic remodeling (stabilization or decrease in aortic diameter at 1-year CT scan).
Main Results:
- Sixty percent (12/20) of patients achieved complete FL thrombosis; 40% (8/20) had partial thrombosis.
- Positive aortic remodeling was observed in 65% (13/20) of patients.
- Aortic diameter decreased or stabilized in 65% of patients; 10% experienced procedure-related complications.
Conclusions:
- Circulating false lumen occlusion (CFLO) is a feasible and effective endovascular technique for chronic aneurysmal descending aortic dissection.
- CFLO successfully induces false lumen thrombosis and promotes positive aortic remodeling, reducing aneurysmal progression.
- This approach offers a valuable option for managing complex aortic pathologies, improving patient outcomes.
Purpose:
To evaluate the efficacy of endovascular circulating false lumen occlusion (CFLO) in inducing positive aortic remodeling in chronic aneurysmal descending aortic dissection (AD).
Methods:
This retrospective monocentric study included patients treated by CFLO between 2003 and 2022 in the context of chronic AD with progressive descending aneurysmal evolution and persistent circulating false lumen (FL). The procedure was achieved with coils, plugs, and/or glue at the entry tear or in the FL and/or with covered stenting in the supra-aortic trunk. The primary endpoint evaluated the positive aortic remodeling, defined as stabilization or a decrease in the aortic diameter on a computed tomography scan at the 1-year follow-up after the procedure. The FL circulating status, safety, and occurrence of aneurysm events during follow-up were also evaluated.
Results:
Twenty patients [median age: 65.4 years, interquartile range (IQR): 58.4–69.9; 13 men] were included, with a median duration from an acute AD of 32.5 months (IQR: 8.8–76.5). Twelve patients (60%) achieved complete FL thrombosis after CFLO, whereas 8/20 patients (40.0%) experienced partial thrombosis. Additionally, positive aortic remodeling was observed in 13 patients (65%). Following the procedure, the aneurysmal aortic diameter decreased in 8/20 patients (40.0%) and remained stable in 5/20 patients (25.0%). Two patients (10%) had complications related to the procedure. Two patients (10%) had secondary aneurysm events during follow-up.
Conclusion:
CFLO is a feasible and efficient method to induce FL thrombosis and reduce aneurysmal progression in chronic AD.
Clinical Significance:
The positive outcomes observed highlight the potential of this technique to improve patient management in complex aortic pathologies. This approach offers a valuable option in the management of chronic AD and emphasizes the importance of endovascular interventions in enhancing patient outcomes.
