Satisfactory short-term outcomes of the STABILISE technique for type B aortic dissection
Satisfactory short-term outcomes of the STABILISE technique for type B aortic dissection
复制标题
DOI：
10.1016/j.jvs.2018.01.029
复制
发表时间：
2018-10-01
影响因子：
4.3
通讯作者：
Chiesa, Roberto
中科院分区：
文献类型：
--
作者：
Melissano, Germano;Bertoglio, Luca;Chiesa, Roberto
目的：本研究的目的是评估去年在我们机构接受主动脉夹层支架辅助球囊诱导内膜破裂和再层叠 (STABILISE) 技术治疗急性复杂主动脉夹层的一组患者的围手术期和短期结果。方法：2016 年 6 月至 2017 年 6 月期间，10 名患者（均为男性；平均年龄，62.6 +/- 7.4 岁）接受了以下治疗：使用 STABILIZE 技术治疗急性复杂主动脉夹层。使用市售的血管内解剖系统（印第安纳州布卢明顿库克医疗公司）进行标准临时延伸以诱导完全附着手术后，远端支架移植区域和裸支架区域膨胀以完全排除胸假腔（FL）并获得单通道腹主动脉。计算机断层扫描通常在术后第一周出院前进行，然后在 3 个月、6 个月以及此后每年进行一次。分析技术和临床成功率。结果：30天技术和临床成功率均为100%，胸FL血栓完全形成，无I型内漏。所有病例的灌注不良均得到解决。没有记录到主动脉破裂，也不需要进行开放性转换。 1 例迟发性脊髓缺血在出院期间完全缓解。出院前计算机断层扫描显示所有病例的胸椎FL完全血栓形成。在两个病例中，观察到腹部FL有一定程度的通畅。在短期随访中，主动脉总体直径保持稳定，没有进一步扩张。结论：STABILIZE 技术在这组患者中是安全可行的，大多数情况下胸部 FL 完全血栓形成并形成单通道主动脉。需要进一步的研究来确定接受治疗的主动脉的长期行为。
Objective: The aim of this study was to evaluate the perioperative and short-term results in a cohort of patients treated during the last year at our institution with the stent-assisted balloon-induced intimal disruption and relamination in aortic dissection repair (STABILISE) technique for acute complicated aortic dissection.Methods: Between June 2016 and June 2017, 10 patients (all male; mean age, 62.6 +/- 7.4 years) received treatment for acute complicated aortic dissection with the STABILISE technique. After a standard provisional extension to induce complete attachment procedure using the commercially available endovascular dissection system (Cook Medical, Bloomington, Ind), the distal stent graft area and the bare stent area were ballooned to completely exclude the thoracic false lumen (FL) and to obtain a single-channeled abdominal aorta. Computed tomography was routinely performed within the first postoperative week before discharge and then at 3 months, at 6 months, and yearly thereafter. The technical and clinical success rates were analyzed.Results: The 30-day technical and clinical success rates were 100%, with complete thrombosis of the thoracic FL and no type I endoleak. Malperfusion was resolved in all cases. No aortic ruptures were recorded, and no open conversion was required. One case of delayed spinal cord ischemia fully resolved within the discharge period. Predischarge computed tomography showed complete thrombosis of the thoracic FL in all cases. In two cases, some degree of patency of the abdominal FL was observed. At short-term follow-up, the overall aortic diameters remained stable with no further dilation.Conclusions: The STABILISE technique was safe and feasible in this cohort of patients, with complete thrombosis of the thoracic FL and creation of a single-channeled aorta in most cases. Further studies are needed to ascertain the long-term behavior of the treated aorta.