REVIEW  RECENT DEVELOPMENTS IN THE MANAGEMENT OF AORTIC DISSECTIONS 

The Journal of Cardiovascular Surgery 2018 December;59(6):784-8

DOI: 10.23736/S0021-9509.18.10638-0

Copyright © 2018 EDIZIONI MINERVA MEDICA

language: English

Techniques and outcomes of false lumen embolization in chronic type B aortic dissection

Fiona ROHLFFS ✉, Konstantinos SPANOS, Nikolaos TSILIMPARIS, Eike S. DEBUS, Tilo KÖLBEL

Department of Vascular Medicine, German Aortic Center, University Heart Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany

Endovascular strategies have been increasingly used for the treatment of chronic type B aortic dissection (cTBAD) offering better outcomes in terms of mortality and morbidity compared to open surgical repair. Aortic remodeling after standard TEVAR is less likely in cTBAD due to rigidity of the dissection membrane. Another limitation of endovascular therapy is continued retrograde false lumen perfusion with back-flow from distal entry tears. Treatment strategies in cTBAD should aim at false lumen thrombosis. There are many approaches to achieve this goal of false lumen thrombosis, but concepts as open surgery or fenestrated and branched endovascular repair are limited by either high technical and logistic demands to the surgeon or high rates of mortality and morbidity. False lumen embolization techniques offer less invasive treatment strategies with promising early results. The main strategies for false lumen embolization include the “cork in the bottle neck” technique, the Candy-Plug technique or the Knickerbocker-technique. This article describes technical aspects and early results of these new endovascular techniques of false lumen embolization in chronic aortic dissection.

KEY WORDS: Aneurysm, dissecting - Endovascular procedures - Aorta - Embolization, therapeutic