Satisfactory short-term outcomes of the STABILISE technique for type B aortic dissection

被引:69
作者
Melissano, Germano [1 ]
Bertoglio, Luca [1 ]
Rinaldi, Enrico [1 ]
Mascia, Daniele [1 ]
Kahlberg, Andrea [1 ]
Loschi, Diletta [1 ]
De Luca, Monica [2 ]
Monaco, Fabrizio [2 ]
Chiesa, Roberto [1 ]
机构
[1] Univ Vita Salute San Raffaele, IRCCS, San Raffaele Sci Inst, Div Vasc Surg, Milan, Italy
[2] Univ Vita Salute San Raffaele, IRCCS, San Raffaele Sci Inst, Dept Anesthesia & Intens Care, Milan, Italy
关键词
Aortic dissection; Type B; STABILISE; Bare stent; Ballooning; COMPOSITE DEVICE DESIGN; ENDOVASCULAR TREATMENT; STENT IMPLANTATION; REPAIR; MANAGEMENT; ISCHEMIA; TRUE;
D O I
10.1016/j.jvs.2018.01.029
中图分类号
R61 [外科手术学];
学科分类号
摘要
Objective: The aim of this study was to evaluate the perioperative and short-term results in a cohort of patients treated during the last year at our institution with the stent-assisted balloon-induced intimal disruption and relamination in aortic dissection repair (STABILISE) technique for acute complicated aortic dissection. Methods: Between June 2016 and June 2017, 10 patients (all male; mean age, 62.6 +/- 7.4 years) received treatment for acute complicated aortic dissection with the STABILISE technique. After a standard provisional extension to induce complete attachment procedure using the commercially available endovascular dissection system (Cook Medical, Bloomington, Ind), the distal stent graft area and the bare stent area were ballooned to completely exclude the thoracic false lumen (FL) and to obtain a single-channeled abdominal aorta. Computed tomography was routinely performed within the first postoperative week before discharge and then at 3 months, at 6 months, and yearly thereafter. The technical and clinical success rates were analyzed. Results: The 30-day technical and clinical success rates were 100%, with complete thrombosis of the thoracic FL and no type I endoleak. Malperfusion was resolved in all cases. No aortic ruptures were recorded, and no open conversion was required. One case of delayed spinal cord ischemia fully resolved within the discharge period. Predischarge computed tomography showed complete thrombosis of the thoracic FL in all cases. In two cases, some degree of patency of the abdominal FL was observed. At short-term follow-up, the overall aortic diameters remained stable with no further dilation. Conclusions: The STABILISE technique was safe and feasible in this cohort of patients, with complete thrombosis of the thoracic FL and creation of a single-channeled aorta in most cases. Further studies are needed to ascertain the long-term behavior of the treated aorta.
引用
收藏
页码:966 / 975
页数:10
相关论文
共 15 条
[1]   Experience of the Zenith Dissection Endovascular System in the emergency setting of malperfusion in acute type B dissections [J].
Alsac, Jean-Marc ;
Girault, Antoine ;
El Batti, Salma ;
Abou Rjeili, Marwan ;
Alomran, Faris ;
Achouh, Paul ;
Julia, Pierre ;
Fabiani, Jean-Noel .
JOURNAL OF VASCULAR SURGERY, 2014, 59 (03) :645-650
[2]   Fenestrated Endografting After Bare Metal Dissection Stent Implantation [J].
Barbante, Matteo ;
Sobocinski, Jonathan ;
Maurel, Blandine ;
Azzaoui, Richard ;
Martin-Gonzalez, Teresa ;
Haulon, Stephan .
JOURNAL OF ENDOVASCULAR THERAPY, 2015, 22 (02) :207-211
[3]   Experimental and Clinical Evidence Supporting Septectomy in the Primary Treatment of Acute Type B Thoracic Aortic Dissection [J].
Berguer, Ramon ;
Parodi, Juan C. ;
Schlicht, Marty ;
Khanafer, Khalil .
ANNALS OF VASCULAR SURGERY, 2015, 29 (02) :167-173
[4]  
Bertoglio L, 2017, J CARDIOVASC SURG TO
[5]   Stent-Assisted Balloon-Induced Intimal Disruption and Relamination in Aortic Dissection Repair: The STABILISE concept [J].
Hofferberth, Sophie C. ;
Nixon, Ian K. ;
Boston, Raymond C. ;
McLachlan, Craig S. ;
Mossop, Peter J. .
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 2014, 147 (04) :1240-1245
[6]   Combined proximal stent grafting plus distal bare metal stenting for management of aortic dissection: Superior to standard endovascular repair? [J].
Hofferberth, Sophie C. ;
Newcomb, Andrew E. ;
Yii, Michael Y. ;
Yap, Kelvin K. ;
Boston, Raymond C. ;
Nixon, Ian K. ;
Mossop, Peter J. .
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 2012, 144 (04) :956-962
[7]   Percutaneous bare Z-stent implantation as an alternative to surgery for acute aortic dissection with visceral ischemia [J].
Ito, N ;
Tsunoda, T ;
Nakamura, M ;
Iijima, R ;
Matsuda, K ;
Suzuki, T ;
Takagi, T ;
Hirai, H ;
Yamaguchi, T .
CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, 2003, 58 (01) :95-100
[8]   Perioperative and mid-term results of endovascular management of complicated type B aortic dissection using a proximal thoracic endoprosthesis and selective distal bare stenting [J].
Kische, Stephan ;
D'Ancona, Giuseppe ;
Belu, Ioan Christian ;
Stoeckicht, Yannik ;
Agma, Umut ;
Ortak, Jasmin ;
Ince, Hueseyin .
EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY, 2015, 48 (04) :E77-E84
[9]   Aortic remodeling after endovascular treatment of complicated type B aortic dissection with the use of a composite device design [J].
Lombardi, Joseph V. ;
Cambria, Richard P. ;
Nienaber, Christoph A. ;
Chiesa, Roberto ;
Mossop, Peter ;
Haulon, Stephan ;
Zhou, Qing ;
Jia, Feiyi .
JOURNAL OF VASCULAR SURGERY, 2014, 59 (06) :1544-1554
[10]  
Melissano G, 2016, J CARDIOVASC SURG, V57, P191