Salvage endovascular septectomy in patients with chronic abdominal aortic dissection after failed endovascular aneurysm repair

Interact Cardiovasc Thorac Surg. 2019 Oct 1;29(4):621-624. doi: 10.1093/icvts/ivz128.

Abstract

This study aimed to investigate the efficacy and safety of salvage endovascular septectomy in patients with abdominal chronic aortic dissection (CAD) after endovascular aneurysm repair. A study cohort comprising 6 patients with chronic abdominal aortic dissection after failed endovascular aortic repair [mean age 62.5 (36-69) years] were enrolled to undergo salvage endovascular septectomy. The procedure involved entering the false lumen via the intrinsic visceral entry to perform a confined septectomy using a 'Gigli wire' to merge the true and false lumens. The outcomes were assessed by Digital angiography and computed tomography angiography. All 6 patients were successfully operated on; the diameters of the visceral abdominal aorta and the infrarenal abdominal aorta were similar at 1, 3, 6 and 12 months compared with the baseline; the patency of the visceral branch arteries was also stable at 1, 3, 6 and 12 months compared with the baseline; no occlusion of the visceral branch arteries was noted; no major vascular adverse events or deaths were observed. In this preliminary study, it was proven that salvage endovascular septectomy is a potentially advantageous technique that is safe and effective in the treatment of patients with CAD after failed endovascular aortic repair.

Keywords: Aortic dissection; Arterial intima; Endoluminal repair.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aortic Aneurysm, Abdominal / diagnostic imaging
  • Aortic Aneurysm, Abdominal / surgery*
  • Aortic Aneurysm, Thoracic / diagnostic imaging
  • Aortic Aneurysm, Thoracic / surgery*
  • Aortic Dissection / surgery*
  • Aortography
  • Blood Vessel Prosthesis Implantation / methods*
  • Chronic Disease
  • Cohort Studies
  • Computed Tomography Angiography
  • Endovascular Procedures / methods*
  • Humans
  • Male
  • Middle Aged
  • Reoperation
  • Salvage Therapy
  • Time Factors
  • Treatment Outcome