scholarly journals Blood Rheology Influence on False Lumen Thrombosis in Type B Aortic Dissection

2020 ◽  
Author(s):  
Alireza Jafarinia ◽  
Thomas Stephan Müller ◽  
Ursula Windberger ◽  
Günter Brenn ◽  
Thomas Hochrainer
Keyword(s):  
Aortic Dissection ◽  
False Lumen ◽  
Blood Rheology ◽  
Type B ◽  
Type B Aortic 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

Spinal Cord Ischemia in the Setting of Acute Type B Aortic Dissection: Successful Rescue with Thoracic Endovascular Aortic Repair

2021 ◽  
pp. 153857442110451
Author(s):  
Masaki Kano ◽  
Toru Iwahashi ◽  
Toshiya Nishibe ◽  
Kentaro Kamiya ◽  
Hitoshi Ogino
Keyword(s):  
Spinal Cord ◽  
Aortic Dissection ◽  
Medical Management ◽  
Spinal Cord Ischemia ◽  
False Lumen ◽  
Thoracic Endovascular Aortic Repair ◽  
Endovascular Aortic Repair ◽  
Acute Type ◽  
Type B ◽  
Type B Aortic Dissection

We report 2 cases of successful thoracic endovascular aortic repair (TEVAR) for acute type B aortic dissection (ABAD) complicated with spinal cord ischemia (SCI). Case 1. A 70-year-old gentleman found with an uncomplicated ABAD with false lumen occluded, developed SCI shortly after admission during the initial medical management. Cerebrospinal fluid drainage (CSFD) was initiated followed by emergent TEVAR. SCI improved, and the patient was discharged. Case 2. A 52-year-old gentleman developed uncomplicated ABAD with patent false lumen. 5 hours after admission, he developed SCI during the initial medical management. Emergent TEVAR was performed followed by CSFD, and the SCI improved before discharge. These cases prompted us to address prompt TEVAR for primary entry closure and true lumen dilatation with postoperative hypertensive management to relieve the dynamic obstruction of the segmental arteries responsible for the compromised spinal cord circulation in complicated ABAD.

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

scholarly journals False lumen ejection fraction predicts growth in type B aortic dissection: preliminary results

2019 ◽  
Vol 57 (5) ◽  
pp. 896-903 ◽  
Author(s):  
Nicholas S Burris ◽  
David A Nordsletten ◽  
Julio A Sotelo ◽  
Ross Grogan-Kaylor ◽  
Ignas B Houben ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Growth Rate ◽  
Magnetic Resonance ◽  
Aortic Dissection ◽  
Ejection Fraction ◽  
Flow Rate ◽  
False Lumen ◽  
Type B ◽  
Type B Aortic Dissection ◽  
4D Flow

Abstract OBJECTIVES Current risk assessment strategies in type B aortic dissection are focused on anatomic parameters, although haemodynamic abnormalities that result in false lumen (FL) pressurization are thought to play a significant role in aortic growth. The objective of this study was to evaluate blood flow of the FL using 4D flow magnetic resonance imaging (MRI) and identify haemodynamic and anatomic factors that independently predict the rate of aortic growth. METHODS Patients with dissection of the descending thoraco-abdominal aorta (n = 18) were enrolled in a prospective observational study and underwent 4D flow MRI for haemodynamic assessment of the entry tear and FL. Anatomic parameters were obtained by magnetic resonance angiography and baseline computed tomography. False lumen ejection fraction (FL EF) was defined the ratio of retrograde flow rate at the dominant entry tear during diastole over the antegrade systolic flow rate. RESULTS The median aortic growth rate was 3.5 mm/year (interquartile range 0.5–8.1 mm/year). Entry tear peak velocity was lower in patients with enlarging aortic dimensions (95.5 ± 24.1 vs 128.1 ± 37.4 cm/s, P = 0.039). After adjusting for co-variates FL EF (β = 0.15, P = 0.004), baseline maximal aortic diameter (β = 0.37, P = 0.001) and the entry tear distance from the left subclavian artery (β = 0.07, P = 0.016) were significant predictors of aortic growth rate. CONCLUSIONS Beyond standard anatomic risk factors, FL EF is an independent predictor of aortic growth rate and may represent an intuitive, non-invasive method to estimate FL pressurization and improve patient-specific risk assessment in patients with type B aortic dissection.

Management of a Compromised Frozen Elephant Trunk Due to Acute Type B Aortic Dissection

2020 ◽  
Vol 54 (8) ◽  
pp. 756-759
Author(s):  
Amer Harky ◽  
Robert K. Fisher ◽  
Mark L. Field
Keyword(s):  
Aortic Valve ◽  
Aortic Dissection ◽  
False Lumen ◽  
Acute Type ◽  
Type B ◽  
Frozen Elephant Trunk ◽  
Type B Aortic Dissection ◽  
Elephant Trunk ◽  
Thoracoabdominal Aorta

Purpose: To report a case who required a thoracic endovascular stenting (TEVAR) following the deployment of frozen elephant trunk due to false lumen expansion Case Report: A 47 years old male patient undergone emergency repair of acute type A aortic dissection in 2011 with bioprosthetic aortic root conduit. Seven years later he presented with moderate aortic valve disease and expanding chronic dissection of the aortic arch, therefore a redo operation with replacement of the prosthetic aortic valve, ascending aorta, total arch and deployment of frozen elephant trunk and he was discharged in good health. Several days post discharge he presented with new onset of chest pain and a new dissection involved the thoracoabdominal aorta was noted pressing on the true lumen and the frozen elephant trunk. Following a multi-disciplinary team meeting, TEVAR was deemed as a most appropriate approach and this was achieved successfully, and patient was discharged. At 1 year of follow up, he remains well and asymptomatic. Conclusion: Close imaging follow-up following deployment of a FET is mandatory. A new acute Type B aortic dissection distal to the FET, that causes false lumen propagation parallel to the stented portion, is a surgical emergency and further intervention mandated.

How to Exclude the Dilated False Lumen in Patients after a Type B Aortic Dissection? The Cork in the Bottleneck

2003 ◽  
Vol 10 (2) ◽  
pp. 244-248 ◽  
Author(s):  
Maartje C. Loubert ◽  
Victor P.M. van der Hulst ◽  
Cees De Vries ◽  
Kees Bloemendaal ◽  
Anco C. Vahl
Keyword(s):  
Aortic Dissection ◽  
Stent Graft ◽  
Case Reports ◽  
False Lumen ◽  
Type B ◽  
Type B Aortic Dissection ◽  
Type B Dissection ◽  
Occluder Device ◽  
Stent Graft Implantation ◽  
Graft Implantation

Purpose: To report techniques for excluding the dilated false lumen associated with chronic type B aortic dissection following placement of a stent-graft in the true lumen. Case Reports: Two patients underwent stent-graft implantation for a dilated false lumen after chronic aortic dissection, but the false lumen was not excluded from the circulation by this procedure. The false lumen was obliterated in one case with Greenfield filters and detachable balloons placed above a renal artery orifice that was perfused via the false lumen. This acted like “a cork in the bottleneck” to block retrograde flow into the thoracic portion of the false lumen above the blockade. In the other patient, an occluder device was used as the “cork.” In both cases, a good result was obtained. The occluder device is preferred because deployment is more controllable. Conclusions: An occluder device may be used like a cork in a bottle to exclude the dilated false lumen in the thoracic aorta after a type B dissection.

Thoracic endovascular repair for disseminated intravascular coagulation associated with chronic type B aortic dissection

Vascular ◽  
2020 ◽  
Vol 28 (6) ◽  
pp. 705-707
Author(s):  
Jumpei Yamamoto ◽  
Arudo Hiraoka ◽  
Hidenori Yoshitaka
Keyword(s):  
Aortic Dissection ◽  
Disseminated Intravascular Coagulation ◽  
Endovascular Repair ◽  
Rare Complication ◽  
False Lumen ◽  
Celiac Artery ◽  
Type B ◽  
Type B Aortic Dissection ◽  
Chronic Type ◽  
Intravascular Coagulation

Objectives Chronic disseminated intravascular coagulation is a rare complication of aortic dissection, and its optimal treatment remains controversial. Methods We present a 78-year-old man with repeated hemorrhagic events by disseminated intravascular coagulation due to chronic aortic dissection treated by thoracic endovascular aortic repair. Results Computed tomography angiography at three months revealed a completely thrombosed false lumen from the distal aortic arch to the descending aorta at the celiac artery level. Platelets and D-dimer levels remained stable, and the patient was doing well without hemorrhagic complications. Conclusions Endovascular repair was effective for disseminated intravascular coagulation due to chronic type B aortic dissection.

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