Candy-plug technique for ruptured chronic type B aortic dissection

Ruptured chronic type B aortic dissection is conventionally repaired surgically; however, the mortality is high. We report successful use of the candy-plug technique for ruptured chronic type B aortic dissection. A 62-year-old man with ruptured type IIIb dissection was transferred to our hospital as an emergency. Computed tomography angiography showed a dissecting aorta with a patent false lumen, ruptured proximal descending aorta, distal aortic arch entry, and mediastinal hematoma. Debranching endovascular repair with the candy-plug technique achieved occlusion of the false lumen of the ruptured aortic dissection. The patient recovered uneventfully and the false lumen gradually decreased with no endoleak.

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Management of Residual False Lumen Flow After Thoracic Endovascular Repair in Chronic Type B Aortic Dissection

Cardiology and Cardiovascular Medicine ◽

10.26502/fccm.92920155 ◽

2020 ◽

Vol 04 (05) ◽

Author(s):

Hervé Rousseau ◽

Paul Revel-Mouroz ◽

Charline Zadro ◽

Camille Dambrin ◽

Christophe Cron ◽

...

Keyword(s):

Aortic Dissection ◽

Endovascular Repair ◽

False Lumen ◽

Type B ◽

Type B Aortic Dissection ◽

Chronic Type ◽

Thoracic Endovascular Repair

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Thoracic endovascular repair for disseminated intravascular coagulation associated with chronic type B aortic dissection

Vascular ◽

10.1177/1708538120934575 ◽

2020 ◽

Vol 28 (6) ◽

pp. 705-707

Author(s):

Jumpei Yamamoto ◽

Arudo Hiraoka ◽

Hidenori Yoshitaka

Keyword(s):

Aortic Dissection ◽

Disseminated Intravascular Coagulation ◽

Endovascular Repair ◽

Rare Complication ◽

False Lumen ◽

Celiac Artery ◽

Type B ◽

Type B Aortic Dissection ◽

Chronic Type ◽

Intravascular Coagulation

Objectives Chronic disseminated intravascular coagulation is a rare complication of aortic dissection, and its optimal treatment remains controversial. Methods We present a 78-year-old man with repeated hemorrhagic events by disseminated intravascular coagulation due to chronic aortic dissection treated by thoracic endovascular aortic repair. Results Computed tomography angiography at three months revealed a completely thrombosed false lumen from the distal aortic arch to the descending aorta at the celiac artery level. Platelets and D-dimer levels remained stable, and the patient was doing well without hemorrhagic complications. Conclusions Endovascular repair was effective for disseminated intravascular coagulation due to chronic type B aortic dissection.

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Staged coil embolization after thoracic endovascular stent grafting for aneurysmal chronic type B aortic dissection: A case report

SAGE Open Medical Case Reports ◽

10.1177/2050313x19828903 ◽

2019 ◽

Vol 7 ◽

pp. 2050313X1982890

Author(s):

Takuya Nakayama ◽

Koji Hattori ◽

Takuya Hashizume ◽

Miki Asano

Keyword(s):

Computed Tomography ◽

Aortic Dissection ◽

Coil Embolization ◽

False Lumen ◽

Thoracic Endovascular Aortic Repair ◽

Endovascular Aortic Repair ◽

Type B ◽

Type B Aortic Dissection ◽

Chronic Type ◽

Aortic Repair

We herein describe a 38-year-old woman with Marfan syndrome and chronic type A aortic dissection. Computed tomography showed that the sinus of Valsalva and thoracoabdominal aorta had a diameter of 62 and 55 mm, respectively. After 7 months of a Bentall operation and total arch replacement with the elephant trunk technique, we performed thoracic endovascular aortic repair for an aneurysm of the descending aorta, but we preserved the retrograde flow into the false lumen because it supplied vessels perfusing the spinal cord. Computed tomography angiography 14 months after thoracic endovascular aortic repair showed that the thoracic aortic diameter had increased to 68 mm. We then performed partial (proximal only) coil embolization of the false lumen. After 6 months, the thoracic aortic diameter had decreased to 60 mm and the spinal cord remained perfused via the distal false lumen. Staged coil embolization after thoracic endovascular aortic repair for aneurysmal chronic type B aortic dissection is feasible and can be beneficial.

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ImageTBAD: A 3D Computed Tomography Angiography Image Dataset for Automatic Segmentation of Type-B Aortic Dissection

Frontiers in Physiology ◽

10.3389/fphys.2021.732711 ◽

2021 ◽

Vol 12 ◽

Author(s):

Zeyang Yao ◽

Wen Xie ◽

Jiawei Zhang ◽

Yuhao Dong ◽

Hailong Qiu ◽

...

Keyword(s):

Computed Tomography ◽

Aortic Dissection ◽

Computed Tomography Angiography ◽

Automatic Segmentation ◽

False Lumen ◽

Type B ◽

Type B Aortic Dissection ◽

Baseline Method ◽

Irregular Shapes ◽

Image Dataset

Type-B Aortic Dissection (TBAD) is one of the most serious cardiovascular events characterized by a growing yearly incidence, and the severity of disease prognosis. Currently, computed tomography angiography (CTA) has been widely adopted for the diagnosis and prognosis of TBAD. Accurate segmentation of true lumen (TL), false lumen (FL), and false lumen thrombus (FLT) in CTA are crucial for the precise quantification of anatomical features. However, existing works only focus on only TL and FL without considering FLT. In this paper, we propose ImageTBAD, the first 3D computed tomography angiography (CTA) image dataset of TBAD with annotation of TL, FL, and FLT. The proposed dataset contains 100 TBAD CTA images, which is of decent size compared with existing medical imaging datasets. As FLT can appear almost anywhere along the aorta with irregular shapes, segmentation of FLT presents a wide class of segmentation problems where targets exist in a variety of positions with irregular shapes. We further propose a baseline method for automatic segmentation of TBAD. Results show that the baseline method can achieve comparable results with existing works on aorta and TL segmentation. However, the segmentation accuracy of FLT is only 52%, which leaves large room for improvement and also shows the challenge of our dataset. To facilitate further research on this challenging problem, our dataset and codes are released to the public (Dataset, 2020).

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A Systematic Review of Mid-term Outcomes of Thoracic Endovascular Repair (TEVAR) of Chronic Type B Aortic Dissection

Journal of Vascular Surgery ◽

10.1016/j.jvs.2011.09.062 ◽

2011 ◽

Vol 54 (5) ◽

pp. 1538-1539

Author(s):

S.G. Thrumurthy ◽

A. Karthikesalingam ◽

B.O. Patterson ◽

P.J.E. Holt ◽

R.J. Hinchliffe ◽

...

Keyword(s):

Systematic Review ◽

Aortic Dissection ◽

Endovascular Repair ◽

Type B ◽

Type B Aortic Dissection ◽

Chronic Type ◽

Thoracic Endovascular Repair

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Safety and Effectiveness of TEVAR in Native Proximal Landing Zone 2 for Chronic Type B Aortic Dissection in Patients With Genetic Aortic Syndrome

Journal of Endovascular Therapy ◽

10.1177/15266028211061276 ◽

2021 ◽

pp. 152660282110612

Author(s):

Ahmed Eleshra ◽

Giuseppe Panuccio ◽

Konstantinos Spanos ◽

Fiona Rohlffs ◽

Yskert von Kodolitsch ◽

...

Keyword(s):

Aortic Dissection ◽

False Lumen ◽

Thoracic Endovascular Aortic Repair ◽

Endovascular Aortic Repair ◽

Type B ◽

Type B Aortic Dissection ◽

Chronic Type ◽

Ehlers Danlos Syndrome ◽

Landing Zone ◽

Aortic Repair

Objectives The aim of this study is to report the safety and effectiveness of thoracic endovascular aortic repair (TEVAR) in a native proximal landing zone (PLZ) 2 for chronic type B aortic dissection (TBAD) patients with genetic aortic syndrome (GAS). Methods A retrospective review of a single center database to identify patients with GAS treated with TEVAR in native PLZ 2 for chronic TBAD and thoracic false lumen aneurysm between February 2012 and February 2018 was undertaken. Results In total, 31 patients with GAS (24 Marfan syndrome [MFS], 5 Loeys-Dietz syndrome [LDS], and 2 vascular Ehlers-Danlos syndrome [vEDS]) were treated by endovascular repair. Nineteen patients were treated by TEVAR as index procedures with 8 patients (5 females, mean age = 55, range = 36–79 years old) receiving TEVAR in native PLZ 2. Left subclavian artery (LSA) perfusion was preserved in all 8 patients: by left common carotid artery-LSA bypass in 6 patients, chimney stenting of the LSA in 1 patient, and partial coverage of LSA ostium in 1 patient. Technical success was achieved in all patients (100%). There was no 30 day mortality (0%). The 30 day morbidity (0%) was free from major complications. The median follow-up was 40 months (range = 7–79). One patient died due to non-aortic-related cause. Native PLZ 2 was free from complications in MFS patients (5/8). Two patients with LDS developed type Ia endoleak with aneurysmal progression. One patient was treated by proximal extension with a double inner branched arch stent-graft landing in the replaced ascending aorta. The other one was treated with frozen elephant trunk. Conclusion Thoracic endovascular aortic repair in native PLZ 2 was safe and effective with no early or midterm PLZ complications in patients with MFS with chronic TBAD in this limited series. Native PLZ 2 is not safe in patients with LDS and should only be used in emergencies as a bridging to open repair.

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