IMR Press / RCM / Volume 24 / Issue 5 / DOI: 10.31083/j.rcm2405133
Open Access Original Research
Endovascular Treatment of Complex Aortic Dissection. A Single Center 5 Years' Experience with 36 Patients
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1 Department of Cardiology, angiology and electrophysiology, “Acibadem City Clinic'' University Hospital, 1700 Sofia, Bulgaria
2 Department of Diagnostic Imaging, “Acibadem City Clinic'' University Hospital, 1700 Sofia, Bulgaria
*Correspondence: strahilvasilevhealth@gmail.com (Strahil Vasilev)
Rev. Cardiovasc. Med. 2023, 24(5), 133; https://doi.org/10.31083/j.rcm2405133
Submitted: 30 September 2022 | Revised: 7 January 2023 | Accepted: 2 February 2023 | Published: 27 April 2023
Copyright: © 2023 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.
Abstract

Background: We present an analysis that compares aortic morphological and clinical outcomes of 36 patients, all treated with endovascular uncovered stents implantation preceded or not by stent-graft implantation, or surgical treatment in the context of complex treatment of type A or type B aortic dissection. Methods: Between 2014 and 05/2018 our team treated 36 patients with acute aortic dissection and end-organ ischemia due to true lumen compression. All clinical and periprocedural data were obtained prospectively, followed by a retrospective analysis. The case series aim is to show induction of aortic remodeling by depressurization of the false lumen and increasing the size of the true lumen by non-covered stents implantation in the aorta and its affected side branches. Secondary endpoints were survival, branch patency, true lumen and false lumen size evolution. Results: Results from the diameter of both lumens measured by computed tomography angiography (CTA) before and at least 1 year after the treatment showed statistically significant differences, patent stents, as well as symptomatic improvement in all patients. Both aorta-related and general mortality in this complex group of patients was 0%. Conclusions: The concept of redirection of flow in aortic dissection with non-covered stents was safe, led to positive aorta remodeling and resulted in excellent survival rate.

Keywords
non-covered stents
decompression
aorta remodeling
aorta dissection
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