False Lumen Stent-Grafts for Repair of Post-Dissection Aortic Aneurysms.

Abstract

PURPOSE\nTo evaluate the safety and efficacy of false lumen stent-grafts in the treatment of post-dissection aortic aneurysms.\n\n\nMATERIALS AND METHODS\nEleven patients who underwent endovascular repair using false lumen stent-grafts from January 2016 to June 2019 were included. Among them, two patients had a prior history of type A aortic dissection, while nine had undergone a prior endovascular repair for type B aortic dissection. Computer tomography angiography was performed to evaluate the re-intervention and technical success rate, aortic remodeling, and other related aortic complications.\n\n\nRESULTS\nThe mean age of patients was 55.6 ± 10.4 years. Technical success was achieved in all patients, and neither early mortality nor paralysis occurred. In total, eight visceral branch arteries originating from the false lumen were reconstructed. The true lumen areas at the celiac axis, superior mesenteric artery, renal artery, and abdominal aortic bifurcation were significantly increased from 230.1mm2 to 312.3mm2, 212.1mm2 to 277.5mm2, 209.1mm2 to 291.6mm2, and 214.4mm2 to 300.6mm2, respectively (p < 0.05). The total diameter of the aorta at the four designated levels was stable or shrunk in all patients. At a mean follow-up of 18.9 ± 7.6 months, one patient received re-intervention due to iliac stent-graft occlusion. No aortic-related mortality occurred.\n\n\nCONCLUSIONS\nFalse lumen stent-grafts can safely and effectively treat patients with post-dissection aortic aneurysms. This strategy can be used to promote thrombosis of the false lumen and aortic remodeling. A larger sample and an extended follow-up period are needed to produce more conclusive results.