Role of multi-layer stents in treatment of complex descending aortic pathologies – A single-center experience

T. Melnic1,2 M.D, C.Solomon1 M.D, A. Costache1,2 M.D, Anca Chitic1,2, Maged Mokbel1,2, Constantin Condac1,2. V.S.Costache1,2 MD PhD

  1. Lucian Blaga University, Sibiu, România, NEXTcardio Project
  2. European Hospital Polisano, Sibiu

https://www.pcronline.com/Courses/EuroPCR/Submissions

Background: While treatment of descending aortic disease remains a challenge, the development of multi-layers stents represents a therapeutic option which may improve branches’ permeability after endo-vascular treatment.

Methods: Prospective, observational, single-center study. Primary endpoint was ischaemic events within the first 30 days of the intervention. Secondary endpoints included procedural success, procedural-related mortality, long-term permeability of the coated collateral vessels evaluated by computerised fluid dynamics (CFD), and presence of major ischaemic events during follow-up (average of 18 months). 38 patients with complex thoraco-abdominal aortic pathologies were classified into 3 groups: group-I (type B aortic dissection, N = 16), group-II (residual dissection after type A surgery, N = 4), and group-III (thoraco-abdominal aortic aneurysms, N = 18). All patients underwent multilayer flow modulator (MFM) stent implantation and had descending aorta fully coated, with coverage of all thoraco-abdominal  branches (bronchial, oesophageal, intercostal, supra-diaphragmatic, celiac, renal and genital arteries). CFD analysis was performed and then repeated in all patients during follow-up.

Results: No ischaemic events were documented within the first 30 days of follow-up. Procedural success was obtained in all patients. No late branch occlusion or procedural-related mortality was reported during follow-up period (maximum  of 36 months). CFD analysis confirmed flow lamination in collinear branches with dissection remodelling and reduction of false lumen’s diameter.

Conclusion: MFM is safe and effective in the treatment of complex descending aortic pathologies, with promising results regarding branch permeability and ischaemic complications.

ianuarie 31st, 2019|Publicatii|