Key result
The CTAG device demonstrated favorable conformability in patients with type B aortic dissection, with a median gold marker to inner curvature distance of 0 mm.
Observational (n=23)
No
The CTAG endoprosthesis demonstrates favorable conformability to the aortic arch and promotes positive aortic remodeling in patients with acute and chronic type B aortic dissection.
Supports CTAG selection in type B dissection; hypothesis-generating for remodeling outcomes in prospective trials.
BACKGROUND The aim of this study was to analyze device conformability in TEVAR of acute and chronic (a/c) type B aortic dissections (TBAD) using the Gore Conformable Thoracic Aortic Stent-graft (CTAG). MATERIAL AND METHODS From January 1997 to February 2014, a total of 90 out of 405 patients in our center received TEVAR for TBAD. Since November 2009, 23 patients (16 men; median age: 62 years) were treated with the CTAG. Indications were complicated aTBAD in 15 (65%) and expanding cTBAD in 8 (35%) patients. Primary endpoints were the assessment of device conformability by measuring the distance (D) from the radiopaque gold band marker (GM) at the proximal CTAG end to the inner curvature (IC) of the arch on parasagittal multiplanar reformations of CT angiography, as well as the evaluation of aortic diameter changes following TEVAR. Median follow-up was 13.3 months (range: 2 days to 35 months). RESULTS Primary and secondary success rates were 91.3% (21/23) and 95.6% (22/23), respectively. There was 1 type Ia endoleak, retrograde dissection or primary conversion was not observed. Median GM-IC-D was 0 mm (range: 0 mm to 10 mm). GM-IC-D was associated with zone 2 placement compared to zone 3 (P=0.036). There was no association between GM-IC-D formation and arch type. In aTBAD cases the true lumen significantly increased after TEVAR (P=0.017) and the false lumen underwent shrinkage (P=0.025). In cTBAD patients the false lumen decreased after TEVAR (P=0.036). CONCLUSIONS The CTAG shows favorable conformability and wall apposition in challenging arch pathologies such as TBAD.
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Bischoff et al. (2015) conducted an observational in Type B aortic dissection (acute and chronic) (n=23). Gore Conformable Thoracic Aortic Stent-graft (CTAG) was evaluated on Device conformability (distance from gold band marker to inner curvature of the arch). The CTAG device demonstrated favorable conformability in patients with type B aortic dissection, with a median gold marker to inner curvature distance of 0 mm.
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