Petrov Ivo, Stankov Zoran, Vasilev Strahil, Tasheva Iveta, Kozareva Galina
Department of Cardiology, angiology and electrophysiology, "Acibadem City Clinic" University Hospital, 1700 Sofia, Bulgaria.
Department of Diagnostic Imaging, "Acibadem City Clinic" University Hospital, 1700 Sofia, Bulgaria.
Rev Cardiovasc Med. 2023 Apr 27;24(5):133. doi: 10.31083/j.rcm2405133. eCollection 2023 May.
We present an analysis that compares aortic morphological and clinical outcomes of 36 patients, all treated with endovascular uncovered stents implantation preceded or not by stent-graft implantation, or surgical treatment in the context of complex treatment of type A or type B aortic dissection.
Between 2014 and 05/2018 our team treated 36 patients with acute aortic dissection and end-organ ischemia due to true lumen compression. All clinical and periprocedural data were obtained prospectively, followed by a retrospective analysis. The case series aim is to show induction of aortic remodeling by depressurization of the false lumen and increasing the size of the true lumen by non-covered stents implantation in the aorta and its affected side branches. Secondary endpoints were survival, branch patency, true lumen and false lumen size evolution.
Results from the diameter of both lumens measured by computed tomography angiography (CTA) before and at least 1 year after the treatment showed statistically significant differences, patent stents, as well as symptomatic improvement in all patients. Both aorta-related and general mortality in this complex group of patients was 0%.
The concept of redirection of flow in aortic dissection with non-covered stents was safe, led to positive aorta remodeling and resulted in excellent survival rate.
我们进行了一项分析，比较了36例患者的主动脉形态和临床结局，所有患者均接受了血管内裸支架植入治疗，该治疗在植入覆膜支架之前或之后进行，或者在A型或B型主动脉夹层的复杂治疗中接受了手术治疗。
2014年至2018年5月期间，我们的团队治疗了36例因真腔受压导致急性主动脉夹层和终末器官缺血的患者。所有临床和围手术期数据均前瞻性获取，随后进行回顾性分析。该病例系列的目的是展示通过降低假腔压力和在主动脉及其受影响的侧支植入裸支架来增加真腔大小，从而诱导主动脉重塑。次要终点是生存率、分支通畅情况、真腔和假腔大小的演变。
通过计算机断层扫描血管造影（CTA）在治疗前和治疗后至少1年测量的两个腔的直径结果显示，差异具有统计学意义，支架通畅，并且所有患者的症状均有改善。在这组复杂患者中，与主动脉相关的死亡率和总死亡率均为0%。
使用裸支架重定向主动脉夹层血流的概念是安全的，可导致主动脉正向重塑，并产生优异的生存率。
