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Volumetric analysis in primary and residual type B aortic dissection treated with stented-assisted balloon-induced intimal disruption and relamination technique can predict aortic reintervention

Ferraresi, Marco ; Molinari, Alessandro Carlo Luigi ; Katsarou, Maria ; Rossi, Giovanni

Journal of vascular surgery, 2024-06, Vol.79 (6), p.1315-1325 [Periódico revisado por pares]

United States: Elsevier Inc

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Volumetric analysis in primary and residual type B aortic dissection treated with stented-assisted balloon-induced intimal disruption and relamination technique can predict aortic reintervention
Autor: Ferraresi, Marco ; Molinari, Alessandro Carlo Luigi ; Katsarou, Maria ; Rossi, Giovanni
Assuntos: Aged ; Angioplasty, Balloon - adverse effects ; Angioplasty, Balloon - instrumentation ; Aorta ; Aortic Aneurysm - diagnostic imaging ; Aortic Aneurysm - surgery ; Aortic Aneurysm, Thoracic - diagnostic imaging ; Aortic Aneurysm, Thoracic - surgery ; Aortic dissection ; Aortic Dissection - diagnostic imaging ; Aortic Dissection - surgery ; Aortic remodeling ; Aortography ; Blood Vessel Prosthesis Implantation - adverse effects ; Blood Vessel Prosthesis Implantation - instrumentation ; Computed Tomography Angiography ; Endovascular ; Endovascular Procedures - adverse effects ; Endovascular Procedures - instrumentation ; Female ; Humans ; Male ; Middle Aged ; Predictive Value of Tests ; Reoperation ; Retrospective Studies ; Risk Factors ; STABILISE ; Stents ; Time Factors ; Treatment Outcome ; Vascular Remodeling ; Volumetric analysis
É parte de: Journal of vascular surgery, 2024-06, Vol.79 (6), p.1315-1325
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Descrição: The aim of this study was to investigate the mid-term results of stented-assisted balloon-induced intimal disruption and relamination (STABILISE) in patients with aortic dissection with the implementation of volumetric analysis. This was a single-center retrospective analysis of prospectively collected data. From May 2017 to September 2022, 42 patients underwent STABILISE for acute complicated or subacute high-risk aortic dissection. STABILISE was completed with distal extended endovascular aortic repair in 24 patients. A computed tomography scan was performed at baseline, before hospital discharge, and at 1, 3, and 5 years. Perfused total aortic, true lumen, and false lumen volumes were assessed for thoracic, visceral, and aorto-iliac segment. The ratio between false lumen and total volume was named perfusion dissection index (PDI). Complete remodeling was defined as PDI = 0, and positive remodeling as PDI ≤0.1. Technical success was 97.6%. No 30-day deaths, spinal cord injuries, or retrograde dissections were observed. Mean follow-up was 44 ± 19.4 months. Thoracic diameter was lower at last available computed tomography scan (36.7 vs 33.0 mm; P = .01). Aortic growth >5 mm was observed in 9.5% of the patients. Thoracic and visceral aortic complete remodeling were 92.8% and 83.3%, respectively, with no difference between acute and subacute group. Distal extended endovascular aortic repair significantly increased complete remodeling in the aorto-iliac segment, compared with STABILISE alone (69.6% vs 21.4%; P < .001). Freedom from vascular reinterventions at 3 years was 83.1% (95% confidence interval, 71.5%-96.6%). Total PDI ≤0.1 at first postoperative control was a predictor of vascular reinterventions (P < .0001). STABILISE is a safe and feasible technique associated with high mid-term rates of complete remodeling in the thoracic and visceral aorta. Volumetric analysis allows the quantification of aortic remodeling and represents a predictor of aortic reinterventions.
Editor: United States: Elsevier Inc
Idioma: Inglês

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Volumetric analysis in primary and residual type B aortic dissection treated with stented-assisted balloon-induced intimal disruption and relamination technique can predict aortic reintervention

Ferraresi, Marco ; Molinari, Alessandro Carlo Luigi ; Katsarou, Maria ; Rossi, Giovanni

United States: Elsevier Inc

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