Evaluation of endovascular procedures for abdominal false lumen repair in patients with post-dissection aortic...

Several endovascular strategies for post-dissection aortic aneurysm (PDAA) have been reported to show benefits and lower morbidity. This study aimed to investigate the potential benefits of the candy plug and double splint technique on abdominal false lumen repair in patients with PDAA.

Patients with PDAA who received the candy plug or double splint technique for abdominal false lumen (FL) repair between November 2016 and December 2022 were retrospectively included. The mean age of patients was 49.1 ± 11.5 years (range: 27-79 years). The medical records were reviewed, and computed tomography results were utilized to evaluate the aortic remodeling after surgery.

Technical success was achieved in all patients without any intraoperative complications, or mortality. In patients receiving the candy plug technique, the true lumen (TL) areas at the celiac axis (p = 0.039) and superior mesenteric artery (p = 0.008) levels were significantly increased. In patients receiving the double splint technique, the TL areas at the celiac axis (p = 0.031), superior mesenteric artery (p = 0.016) and renal artery (p = 0.047) levels were significantly increased. No obvious FL expansion or operation-related complication/mortality was noted in patients receiving either procedure during the follow-up period.

The abdominal FL expansion could be limited by both candy plug and double splint technique, which reduces the possibility of aneurysm rupture. Moreover, the aortic remodeling regarding the TL expansion was observed for both techniques. The safety of the procedures was considered acceptable. A larger sample size and longer follow-up period are needed to confirm the preliminary results.