Long-Term Volumetric Evaluation of Stent-Assisted Balloon-Induced Intimal Disruption and Relamination of Aortic Dissection (STABILISE) in Acute Type B Aortic Dissection

Ann Vasc Surg. 2025 Jan;110(Pt B):362-372. doi: 10.1016/j.avsg.2024.07.101. Epub 2024 Aug 3.

Abstract

Background: To quantify the volumetric aortic remodeling of patients with acute type B aortic dissection treated with the stent-assisted balloon-induced intimal disruption and relamination (STABILISE) technique.

Methods: All patients with acute type B aortic dissection operated with the STABILISE technique between 2014 and 2017 with preoperative, postoperative, and >12 months (follow-up) computed tomography scans were included in this study. True lumen and total aortic volume were accurately assessed in the thoracic and abdominal portions with a semiautomatic three-dimensional tool. Associations with long-term adverse events were estimated.

Results: Seventeen patients were measured at preoperative, postoperative, and a mean follow-up of 19 ± 8 months. The false lumen to total volume ratio decreased on average from 63% to 18% after STABILISE (P < 0.001) and remained around 12% at follow-up. These remodeling was more pronounced in the thoracic aorta (7%) than in the abdominal aorta (28%). The trend in aortic size growth was stronger for volumes than for maximum areas or diameters (P < 0.001, P < 0.05, and P < 0.05, respectively). Adverse events were identified in 4 patients during a long-term follow-up of 76 ± 18 months. The only aortic size variable assessed preoperatively that was associated with undesirable events was the total volume of the abdominal aorta (P < 0.05).

Conclusions: A volumetric analysis of dissected aortic size after the STABILISE procedure allowed accurate quantification of mid-term aortic remodeling and helped to identify the abdominal aortic volume as a preoperative variable associated with undesirable long-term events.

MeSH terms

  • Acute Disease
  • Aged
  • Angioplasty, Balloon / adverse effects
  • Angioplasty, Balloon / instrumentation
  • Aortic Aneurysm / diagnostic imaging
  • Aortic Aneurysm / etiology
  • Aortic Aneurysm / surgery
  • Aortic Aneurysm, Thoracic / diagnostic imaging
  • Aortic Aneurysm, Thoracic / surgery
  • Aortic Dissection* / diagnostic imaging
  • Aortic Dissection* / etiology
  • Aortic Dissection* / surgery
  • Aortography*
  • Blood Vessel Prosthesis Implantation / adverse effects
  • Blood Vessel Prosthesis Implantation / instrumentation
  • Computed Tomography Angiography*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Radiographic Image Interpretation, Computer-Assisted
  • Retrospective Studies
  • Stents*
  • Time Factors
  • Treatment Outcome
  • Vascular Remodeling*