Montagner Matteo, Heck Roland, Kofler Markus, Buz Semih, Starck Christoph, Sündermann Simon, Kurz Stephan, Falk Volkmar, Kempfert Germany Dzhk German Centre For Cardiovascular Research Partner Site Berlin Germany Jörg
Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum, Berlin, Germany.
Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum, Berlin, Germany, Germany, DZHK (German Centre for Cardiovascular Research), Partner Site, Berlin, Germany.
Surg Technol Int. 2020 May 28;36:95-97.
Acute type A aortic dissection (ATAAD) is a surgical emergency with high rates of morbidity and mortality. The treatment of ATAAD is highly individualized and mainly depends on anatomical and technical factors. Great efforts to reduce the time to diagnosis and technological innovations have led to improved surgical results with a lower rate of dissection-related reoperations during long-term follow up. The aim of this article is to introduce a novel hybrid device for the treatment of DeBakey I acute aortic dissection.
A non-covered hybrid stent from Ascyrus Medical (Boca Raton, FL, USA) aims to improve the current standard of care, without increasing technical complexity or device-related complications. The AMDS (Ascyrus Medical Dissection Stent) prolongs the hemiarch operation by only a few minutes, does not need endovascular skills to be deployed, and provides an anatomical and "haemodynamic" correction. The device is intended to reduce perfusion of the false lumen by sealing the distal anastomosis, and to restore distal perfusion of the true lumen. Obliteration of the false lumen at the distal anastomosis is likely to reduce aortic enlargement and the need for reoperations, mainly driven by a low-flow state and pressure reduction, which promote thrombosis.
The AMDS provides a new concept to treat acute aortic dissection by moving the focus from resecting the dissected tissue to restoring adequate true-lumen flow and sealing the false lumen at the distal anastomosis. With a high rate of procedural success, AMDS represents a safe, reproducible and promising solution to treat DeBakey I aortic dissections.
急性A型主动脉夹层（ATAAD）是一种具有高发病率和死亡率的外科急症。ATAAD的治疗高度个体化，主要取决于解剖学和技术因素。为减少诊断时间所做的巨大努力以及技术创新已使手术结果得到改善，在长期随访期间与夹层相关的再次手术率降低。本文的目的是介绍一种用于治疗DeBakey I型急性主动脉夹层的新型混合装置。
Ascyrus Medical公司（美国佛罗里达州博卡拉顿）的一种无覆膜混合支架旨在提高当前的治疗标准，而不增加技术复杂性或与装置相关的并发症。AMDS（Ascyrus Medical夹层支架）将半弓手术延长仅几分钟，不需要部署血管内技术，并提供解剖学和“血流动力学”矫正。该装置旨在通过封闭远端吻合口来减少假腔的灌注，并恢复真腔的远端灌注。远端吻合口处假腔的闭塞可能会减少主动脉扩张以及再次手术的需求，这主要是由促进血栓形成的低流量状态和压力降低所驱动的。
AMDS通过将重点从切除夹层组织转移到恢复足够的真腔血流并在远端吻合口封闭假腔，为治疗急性主动脉夹层提供了一种新概念。凭借高手术成功率，AMDS是治疗DeBakey I型主动脉夹层的一种安全、可重复且有前景的解决方案。
