Journal of Surgery Concepts & Practice >

2022 , Vol. 27 >Issue 05: 458 - 462

DOI: https://doi.org/10.16139/j.1007-9610.2022.05.015

Original article

Spot stenting combined with false lumen endovascular occlusive repair in treatment of postoperative aortic dissecting aneurysm

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  • 1. Department of Vascular Surgery, Zhongshan Hospital, Institute of Vascular Surgery, Fudan University, Shanghai 200032, China
    2. Department of Vascular Surgery, Zhongshan Hospital (Xiamen), Fudan University, Fujian Xiamen 361015, China

Online published: 2022-11-10

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Abstract

Objective To retrospectively evaluate the mid-term outcome of spot stenting combined with false lumen endovascular occlusive repair(SS-FLEVOR) in the treatment of postoperative aortic dissection aneurysm. Methods Both perioperative and follow-up data of the patients with aortic dissection aneurysm after thoracic endovascular aortic repair (TEVAR) who underwent SS-FLEVOR from October 2016 to October 2020 were collected and analyzed. The preoperative and postoperative largest diameters of both thoracic aortic true lumen and abdominal aortic true lumen were analyzed combined with the thrombus in false lumen and stents patency of visceral arteries. Results A total of 17 cases were enrolled with an average age of (54.5±14.5) years and 3 cases female. SS-FLEVOR was all successful. Mean operative time was (151.4±37.9) min with follow-up time of (24.9±20.7) months. During the follow-up period, the stents in visceral arteries were all patent. Thrombus was formed in thoracoabdominal aortic false lumen 10 cases and in thoracic false lumen 3 cases. Partial blood flow was found 4 cases in thoracoabdominal aortic false lumen. The sac size did not increase due to decreasing in blood flow of the false lumen gradually and secondary intervention was not needed. The true lumens diameter increased compared with those of preoperative for thoracic aorta [(2.1±0.6) cm vs. (1.7±0.7) cm, P=0.001] and for abdominal aorta [(1.4±0.6) cm vs. (1.1±0.4) cm, P=0.001]. The diameter of true lumen decreased in 1 case after six months post operation (1.3 cm vs. 1.7 cm) due to the compression caused by the stent-graft in false lumen. There was no stent displacement, paraplegia, infection, visceral artery stent occlusion and other complications occured during the period of follow-up. Conclusions SS-FLEVOR might be relatively safe, effective and feasible with satisfied results for specific cases.

Key words： Thoracic endovascular aortic repair; Chronic aortic dissecting aneurysm; Distal tear; False lumen embolization

Cite this article

YUAN Ye, ZHOU Min, WANG Enci, LI Zheyun, ZHANG Yuchong, LIN Peng, MO Fandi, GUO Daqiao, FU Weiguo, WANG Lixin . Spot stenting combined with false lumen endovascular occlusive repair in treatment of postoperative aortic dissecting aneurysm[J]. Journal of Surgery Concepts & Practice, 2022 , 27(05) : 458 -462 . DOI: 10.16139/j.1007-9610.2022.05.015

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