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Theoretical Applicability of Different Occluder Systems for Entry Closure in Type B Aortic Dissection: An
Miroslav Yordanov1, Alexander Oberhuber1, Johannes Frederik Schäfers1
1Department of Vascular and Endovascular Surgery, University Hospital Muenster, Albert-Schweitzer-Campus 1, 48149 Muenster, Germany.
Biomedicines
|October 29, 2025
Summary
This study evaluated the theoretical use of occluder systems for sealing primary entry tears in type B aortic dissection (TBAD) and distal stent graft-induced new entry (dSINE). The Amplatzer™-Occluder showed the highest applicability (90.1%), but potential coverage of aortic branches remains a concern.
Area of Science:
- Cardiovascular Surgery
- Medical Device Technology
- Radiology
Background:
- Type B aortic dissection (TBAD) is a critical condition requiring intervention.
- Thoracic endovascular aortic repair (TEVAR) is the standard for operative management.
- Selective endovascular entry sealing is an emerging strategy.
Purpose of the Study:
- To assess the theoretical applicability of different occluder systems for sealing primary entry tears.
- To analyze the efficacy and potential complications of using ASD-Occluder, Septal-Occluder, and Amplatzer™-Occluder.
Main Methods:
- CT-graphic analysis of 102 patients (87 TBAD, 15 dSINE) who underwent TEVAR.
- Exclusion of patients with intramural hematoma.
- Evaluation of occluder system applicability based on CTA and Instructions for Use (IFU).
Main Results:
- Amplatzer™-Occluder demonstrated the highest technical applicability (90.1%), followed by ASD-Occluder (81.4%) and Septal-Occluder (57.5%).
- Potential for unintentional partial or complete coverage of adjacent aortic branches was observed with all systems (3.9-23.5%).
- The ASD-Occluder could lead to complete LSA coverage in 10.3% of patients.
Conclusions:
- Theoretical application of occluder systems can achieve entry sealing in a significant percentage of TBAD and dSINE patients.
- Risk of unintended coverage of aortic branches necessitates further investigation.
- Clinical significance, safety, and efficacy require evaluation in future studies.
