Volume 42, Pages (January 2019)

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Presentation transcript:

Volume 42, Pages 26-30 (January 2019) Aortic Dissection Repair Using the STABILISE Technique Associated with Arch Procedures: Report of Two Cases Alice Lopes, Ryan Gouveia Melo, Miguel L. Gomes, Pedro Garrido, Nádia Junqueira, Gonçalo Sobrinho, Ruy Fernandes e Fernandes, João Leitão, Ângelo Nobre, Luís M. Pedro EJVES Short Reports Volume 42, Pages 26-30 (January 2019) DOI: 10.1016/j.ejvssr.2019.01.003 Copyright © 2019 The Authors Terms and Conditions

Figure 1 I. Pre-operative computed tomography angiography of a “subacute” type A aortic dissection. Axial scans with the true (*) and false (**) lumens at the level of the descending thoracic aorta (A), thoraco-abdominal junction (B), celiac trunk (C), superior mesenteric artery (D), and renal arteries (E). II. Computed tomography angiography after STABILISE procedure at the same levels with complete remodelling of the thoraco-abdominal aorta. EJVES Short Reports 2019 42, 26-30DOI: (10.1016/j.ejvssr.2019.01.003) Copyright © 2019 The Authors Terms and Conditions

Figure 2 Ascending aorta and arch replacement using a hybrid stent graft system, over a previously inserted stiff wire, thus allowing the creation of a “frozen elephant trunk” and a proximal landing zone for the endovascular stage (A and B); aortic dissection (C). EJVES Short Reports 2019 42, 26-30DOI: (10.1016/j.ejvssr.2019.01.003) Copyright © 2019 The Authors Terms and Conditions

Figure 3 Schematic representation of the STABILISE technique. (A) Type B aortic dissection. (B) After implantation of a proximal covered stent graft and placement of a distal bare metal stent, with residual flow in the false lumen (PETTICOAT technique). (C) Intimal re-apposition after ballooning the stent graft and dissection stent with obliteration of the false lumen (STABILISE technique). EJVES Short Reports 2019 42, 26-30DOI: (10.1016/j.ejvssr.2019.01.003) Copyright © 2019 The Authors Terms and Conditions

Figure 4 I. Pre-operative computed tomography angiography of a chronic type B aortic dissection. Axial scans with the true (*) and false (**) lumens at the level of the descending thoracic aorta (A), thoraco-abdominal junction (B), celiac trunk (C), superior mesenteric artery (D), and renal arteries (E). II. CTA after STABILISE procedure at the same levels with complete remodelling of the thoraco-abdominal aorta. EJVES Short Reports 2019 42, 26-30DOI: (10.1016/j.ejvssr.2019.01.003) Copyright © 2019 The Authors Terms and Conditions

Figure 5 Sequential ballooning of the bare metal stent in a caudal direction with progressive expansion of the stent and consequent reapposition of the flap to the outer aortic wall. EJVES Short Reports 2019 42, 26-30DOI: (10.1016/j.ejvssr.2019.01.003) Copyright © 2019 The Authors Terms and Conditions

Figure 6 Post-operative computed tomography angiography of a chronic type B aortic dissection showing a patent left vertebral artery reimplanted in the left common carotid artery. EJVES Short Reports 2019 42, 26-30DOI: (10.1016/j.ejvssr.2019.01.003) Copyright © 2019 The Authors Terms and Conditions