scholarly journals Coil-assisted false lumen thrombosis in complicated chronic type B dissection

2008 ◽  
Vol 48 (2) ◽  
pp. 465-468 ◽  
Author(s):  
Eric Hager ◽  
Neil Moudgill ◽  
Adam Lipman ◽  
Paul DiMuzio ◽  
Joseph Lombardi
Keyword(s):  
False Lumen ◽  
Type B ◽  
Chronic Type ◽  
Type B Dissection

Distal Neo-Neck Formation for Chronic Type B Dissection: False Lumen Closure After TEVAR

2018 ◽  
Vol 53 (3) ◽  
pp. 199-205 ◽  
Author(s):  
Masato Furui ◽  
Shoji Sakaguchi ◽  
Bunpachi Kakii ◽  
Gaku Uchino ◽  
Mai Asanuma ◽  
...  
Keyword(s):  
False Lumen ◽  
Additional Treatment ◽  
Type B ◽  
Chronic Type ◽  
Direct Closure ◽  
Descending Aorta ◽  
Type B Dissection ◽  
Enhanced Computed Tomography ◽  
Staged Treatment ◽  
Open Surgical Approach

Objectives: Patients with chronic aortic dissection often require repeat interventions due to enlargement of the pressurized false lumen or disseminated intravascular coagulation even after additional thoracic endovascular aortic repair (TEVAR) to occlude the entry tear. Residual false lumen flow can persist even after performing the candy-plug technique or branched stent-graft placement in some cases. We have devised a new method for false lumen closure. Methods: From December 2010 to May 2017, 5 patients (mean age: 57 [13] years, range: 43-77 years) with chronic dissection at the aortic arch and descending aorta, who underwent initial TEVAR, required additional treatment. Using an open surgical approach, the endograft was fixed with an outer felt under cardiopulmonary bypass after the endograft with stent was expanded by fenestration. The false lumen was closed using this procedure, and the aortotomy was repaired by direct closure in 2 cases and by graft replacement in 3 cases. Results: No major operative complications occurred, such as respiratory failure or paraplegia. Postoperative enhanced computed tomography (CT) images showed that the false lumen flow disappeared in all cases. All patients were discharged under normal conditions. They were all followed up and their CT did not indicate any complications for a mean of 33.6 (20.3) months. Conclusions: Our combined procedure was effective and provided a higher success rate compared with endovascular therapy alone. This staged treatment approach, using a combination of TEVAR and false lumen closure, is less invasive compared with open surgery alone and may represent a valid treatment option for chronic type B dissection.

Management of Residual False Lumen Flow After Thoracic Endovascular Repair in Chronic Type B Aortic Dissection

2020 ◽  
Vol 04 (05) ◽  
Author(s):  
Hervé Rousseau ◽  
Paul Revel-Mouroz ◽  
Charline Zadro ◽  
Camille Dambrin ◽  
Christophe Cron ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Endovascular Repair ◽  
False Lumen ◽  
Type B ◽  
Type B Aortic Dissection ◽  
Chronic Type ◽  
Thoracic Endovascular Repair

scholarly journals Surgery for chronic type B dissection with aneurysmal degeneration

2018 ◽  
Vol 35 (S2) ◽  
pp. 169-173
Author(s):  
Jeremy R. Leonard ◽  
Christopher Lau ◽  
Erin M. Iannacone ◽  
Mario F. L. Gaudino ◽  
Monica Munjal ◽  
...  
Keyword(s):  
Type B ◽  
Chronic Type ◽  
Type B Dissection

A Novel Insight into the Role of Entry Tears in Type B Aortic Dissection: Pressure Measurements in an in Vitro Model

2017 ◽  
Vol 40 (10) ◽  
pp. 563-574 ◽  
Author(s):  
Stefania Marconi ◽  
Ettore Lanzarone ◽  
Hector De Beaufort ◽  
Michele Conti ◽  
Santi Trimarchi ◽  
...  
Keyword(s):  
False Lumen ◽  
Patient Characteristics ◽  
Acute Type ◽  
Type B ◽  
Type B Dissection ◽  
Vitro Model ◽  
Insight Into

Introduction Predicting aortic growth in acute type B dissection is fundamental in planning interventions. Several factors are considered to be growth predictors in the literature and, among them, size and location of entry tears have been recognized to particularly influence the false lumen pressure. In this study, we develop an in vitro setting to analyze the actual impact of size and location of the entry tears on false lumen pressure, in the absence of other confounding factors such as the deformability of the aortic wall. Methods We formalize some indexes that synthetically describe the false lumen pressure with respect to the true lumen pressure. Then, we experimentally derive their values in several configurations of the in vitro setting, and we look for trends in the indexes with respect to the size and location of entry tears. Results: Results show that the tears have a relevant impact on the false lumen pressure, but that their size and location alone are not enough to explain the phenomena observed in vivo. Conclusions To predict the behavior of acute type B dissection, we therefore recommend not limiting to size and location, as many effects may derive from the interactions between these parameters and other patient characteristics.

Safety and Effectiveness of TEVAR in Native Proximal Landing Zone 2 for Chronic Type B Aortic Dissection in Patients With Genetic Aortic Syndrome

2021 ◽  
pp. 152660282110612
Author(s):  
Ahmed Eleshra ◽  
Giuseppe Panuccio ◽  
Konstantinos Spanos ◽  
Fiona Rohlffs ◽  
Yskert von Kodolitsch ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
False Lumen ◽  
Thoracic Endovascular Aortic Repair ◽  
Endovascular Aortic Repair ◽  
Type B ◽  
Type B Aortic Dissection ◽  
Chronic Type ◽  
Ehlers Danlos Syndrome ◽  
Landing Zone ◽  
Aortic Repair

Objectives The aim of this study is to report the safety and effectiveness of thoracic endovascular aortic repair (TEVAR) in a native proximal landing zone (PLZ) 2 for chronic type B aortic dissection (TBAD) patients with genetic aortic syndrome (GAS). Methods A retrospective review of a single center database to identify patients with GAS treated with TEVAR in native PLZ 2 for chronic TBAD and thoracic false lumen aneurysm between February 2012 and February 2018 was undertaken. Results In total, 31 patients with GAS (24 Marfan syndrome [MFS], 5 Loeys-Dietz syndrome [LDS], and 2 vascular Ehlers-Danlos syndrome [vEDS]) were treated by endovascular repair. Nineteen patients were treated by TEVAR as index procedures with 8 patients (5 females, mean age = 55, range = 36–79 years old) receiving TEVAR in native PLZ 2. Left subclavian artery (LSA) perfusion was preserved in all 8 patients: by left common carotid artery-LSA bypass in 6 patients, chimney stenting of the LSA in 1 patient, and partial coverage of LSA ostium in 1 patient. Technical success was achieved in all patients (100%). There was no 30 day mortality (0%). The 30 day morbidity (0%) was free from major complications. The median follow-up was 40 months (range = 7–79). One patient died due to non-aortic-related cause. Native PLZ 2 was free from complications in MFS patients (5/8). Two patients with LDS developed type Ia endoleak with aneurysmal progression. One patient was treated by proximal extension with a double inner branched arch stent-graft landing in the replaced ascending aorta. The other one was treated with frozen elephant trunk. Conclusion Thoracic endovascular aortic repair in native PLZ 2 was safe and effective with no early or midterm PLZ complications in patients with MFS with chronic TBAD in this limited series. Native PLZ 2 is not safe in patients with LDS and should only be used in emergencies as a bridging to open repair.

Flow Diversion: A Novel Technique In The Management Of Aneurysmal False Lumen In Chronic Type B Aortic Dissection

2020 ◽  
Vol 63 ◽  
pp. 10-11
Author(s):  
Motahar Hosseini ◽  
David N. Blitzer ◽  
Anahita Ghazi ◽  
Shahab Toursavadkohi
Keyword(s):  
Aortic Dissection ◽  
False Lumen ◽  
Flow Diversion ◽  
Type B ◽  
Type B Aortic Dissection ◽  
Chronic Type ◽  
Novel Technique

Remodeling, Reintervention, and Survival After Endovascular Repair of Chronic Type B Dissection

2020 ◽  
Author(s):  
Dean J. Arnaoutakis ◽  
Tabassum A. Khan ◽  
Salvatore T. Scali ◽  
Dan Neal ◽  
Kristina A. Giles ◽  
...  
Keyword(s):  
Endovascular Repair ◽  
Type B ◽  
Chronic Type ◽  
Type B Dissection
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