„Role of multi-layer stents in treatment of complex descending aortic pathologies – A single-center experience”, autori: Victor Costache, Tania Melnic, Crina Solomon, Andreea Costache, Anca Chitic, Maged Mokbel, Constantin Condac.
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.