The role of multilayer stents in the treatment of aortic dissection: a single-center experience

Introduction: Reported are up to 36 month outcomes of patients with type B aortic dissection managed by multilayer stents. We present our single center experi-ence and results with this technique.
Objective: Primary endpoint was freedom from ruptu-re or dissection-related death at 18 months. Secondary endpoints were absence of major adverse events, ab-sence of graft rupture or major side branches occlusion. Methods: Patients with complex aortic dissections were selected for Multilayer Flow Modulator Stents (MFMS) endovascular repair and were followed prospectively. Computerized Fluid Dynamics (CFD) analysis for their CT-scans was performed at each follow-up.
Results: 15 patients with aortic dissection, underwent thoracic endovascular aortic repair (TEVAR) with a new generation multilayer aortic stents. Indications in-cluded: type B dissection (n=11), residual type B after type A surgical correction (n=3) and acute type B af-ter surgical correction of a type A dissection requiring immediate intervention for a malperfusion syndrome (n=1). There were no reported ruptures or aortic-re-lated deaths. Initial procedural success was 100% with no branch occlusions during follow-up. All patients are alive with the longest follow up of 36 months and an average follow-up of 18 month. Twelve-month free-dom from neurologic events was 100%, and there were no incidences of end-organ ischemia, paraplegia or re-nal insult. Morphologic CFD analysis was performed with MIMICS that confirmed dissection remodeling by a reduction in false lumen volume and diameter.
Conclusions: MFMS are a safe option in the treatment of complex aortic dissections, with low mortality and good procedural success.

ISSN – online: 2734 – 6382
ISSN-L 1220-658X
ISSN – print: 1220-658X
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CODE: 379
CME Credits: 10 (Romanian College of Physicians)