Key result
Endovascular strategies offer minimally invasive options for post-dissection aortic aneurysms despite limited robust evidence.
Why the study?
Open surgery is the first-choice treatment for post-dissection aortic aneurysm but is associated with high mortality and morbidity, and endovascular repair offers a minimally invasive alternative with early benefits and low morbidity.
What are the available endovascular techniques and their outcomes for the treatment of post-dissection aortic aneurysm (PDAA)?
What are the available endovascular techniques and their outcomes for the treatment of post-dissection aortic aneurysm (PDAA)?
Endovascular repair offers a minimally invasive, safe, and effective alternative to open surgery for managing post-dissection aortic aneurysms by promoting false lumen thrombosis and aortic remodeling.
Endovascular strategies may warrant cautious use in select high-risk cases; leaves open need for prospective trials to define safety and durability.
Residual patent false lumen (FL) after type B aortic dissection (TBAD) repair is independently associated with poor long-term survival. Open surgery and endovascular repair result in good clinical outcomes in patients with AD. However, both treatments focus on proximal dissection but not distal dissection. About 13.4-62.5% of these patients present with different degrees of distal aneurysmal dilatation after primary repair. Although open surgery is the first-choice treatment for post-dissection aortic aneurysm (PDAA), there is a need for high technical demand since open surgery is associated with high mortality and morbidity. As a treatment strategy with minimal invasion, endovascular repair shows early benefits and low morbidity. For PDAA, the narrow true lumen (TL), rigid initial flap and branch arteries originating from FL have increased difficulties in operation. The aim of endovascular treatment is to promote FL thrombosis and aortic remodeling. Endovascular repair includes intervention from FL and TL sides. TL intervention techniques (parallel stent-graft, branched and fenestrated stent-graft among others) have been proven to be safe and effective in PDAA. Other FL intervention techniques that have been used in selected patients include FL embolization and candy-plug techniques. This article introduces available endovascular techniques and their outcomes for the treatment of PDAA.
No takes yet. Share an insight, caveat, or question.
Zeng et al. (2020) conducted a review in Post-dissection aortic aneurysm (PDAA). Endovascular strategies was evaluated. Endovascular strategies, including true lumen and false lumen interventions, provide minimally invasive treatment options for post-dissection aortic aneurysms, though robust clinical evidence is limited.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: