Effect of False Lumen Occlusion Treatment With AFX VELATM, Candy-Plug Technique for Chronic Aortic Dissection.

Vascular and endovascular surgery Pub Date : 2024-07-01 Epub Date: 2024-01-23 DOI:10.1177/15385744241229594
Kiyomitsu Yasuhara, Tamiyuki Obayashi, Satoshi Ohki, Shuichi Okonogi, Ayako Nagasawa, Ryo Yamaguchi, Yusuke Kato, Takao Miki, Tomonobu Abe
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Abstract

Introduction: We sought to examine midterm results and remodeling effect of false-lumen occlusion treatment using AFX VELA in case of chronic dissection repair.

Material and methods: From June 2019 to May 2022, we performed false lumen occlusion treatment using a modified Candy-Plug technique with AFX VELA on 8 chronic aortic dissection patients with a patent false lumen. We collected operative data, short-term clinical outcomes, mid-term clinical outcomes and imaging test results. We conducted follow-up examinations at postoperative, 6-month and 1-, 2- and 3-year intervals, including contrast-enhanced computed tomography to evaluate the diameter, false lumen thrombosis and any events.

Results: The average time from the symptom onset to the thoracic endovascular repair was 81.5 (35-155) months. The aorta showed aneurysmal dilation with an average maximum short-axis diameter of 58.9 (41-91) mm. Two cases needed emergency surgery due to rupture and impending rupture. There were no postoperative deaths. Complete thrombosis within the false lumen was achieved in 6 cases (75%), but 2 cases had incomplete thrombosis, requiring additional treatment. The mean maximum diameter showed a significant decrease at 6 months, 1 year and 2 years postoperatively compared to preoperative measurements (P < .05).

Conclusion: We showed the results of false lumen occlusion treatment using the AFX VELA cuff. We observed favorable clinical outcomes and remodeling effects. While the long-term durability and efficacy of this technique in aortic remodeling will need to be monitored with further observation, the use of this cuff is considered a reliable approach to false lumen occlusion treatment.

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用 AFX VELATM、糖果插管技术治疗慢性主动脉夹层的假腔闭塞效果。
简介我们试图研究在慢性夹层修复病例中使用AFX VELA进行假腔闭塞治疗的中期效果和重塑效果:2019年6月至2022年5月,我们对8例慢性主动脉夹层假腔通畅患者采用改良Candy-Plug技术和AFX VELA进行了假腔闭塞治疗。我们收集了手术数据、短期临床疗效、中期临床疗效和影像学检查结果。我们在术后6个月、1年、2年和3年进行了随访检查,包括对比增强计算机断层扫描,以评估直径、假腔血栓形成和任何事件:从症状出现到胸腔内血管修复的平均时间为81.5(35-155)个月。主动脉出现动脉瘤扩张,平均最大短轴直径为58.9(41-91)毫米。两个病例因破裂和即将破裂而需要紧急手术。术后无死亡病例。6例(75%)在假腔内实现了完全血栓形成,但有2例血栓形成不完全,需要额外治疗。与术前测量结果相比,术后6个月、1年和2年的平均最大直径均有显著下降(P < .05):我们展示了使用 AFX VELA 袖套治疗假腔闭塞的结果。我们观察到了良好的临床效果和重塑效果。虽然这项技术在主动脉重塑方面的长期持久性和有效性还需要进一步观察,但使用这种袖带治疗假腔闭塞被认为是一种可靠的方法。
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