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Article: Urgent Candy-Plug technique for distal false lumen occlusion in chronic aortic dissection

TitleUrgent Candy-Plug technique for distal false lumen occlusion in chronic aortic dissection
Authors
KeywordsAorta
Aortic dissection
Aortic remodeling
Embolization
Endovascular
False lumen
Repair
TEVAR
Issue Date16-Jul-2024
PublisherElsevier
Citation
Journal of Vascular Surgery, 2024, v. 80, n. 5, p. 1418-1424.e1 How to Cite?
Abstract

Objective: This study aimed to assess the impact of urgency on early and midterm outcomes of the Candy-Plug (CP) technique for distal false lumen (FL) occlusion in thoracic endovascular aortic repair for aortic dissection. Methods: The CP registry was reviewed, and patients were categorized into elective and urgent/emergent groups for analysis. End points included technical success, clinical success, early (30-day) computed tomography angiography findings, early (30-day) mortality, adverse events, and aortic remodeling in patients with available computed tomography angiography follow-up and reintervention. Results: A total of 155 patients received a custom-made CP, of whom 32 patients (44% male, mean age 61 ± 9 years) were treated urgently and 123 patients (63% male, mean age 62 ± 11 years) electively. The primary CP rate was higher in the urgent group (28/32, 88%, in the urgent group vs 96/123, 78%, in the elective group, P = .051). The mean contrast volume was higher in the urgent group (157 ± 56 mL in the urgent group vs 130 ± 71 mL in the elective group, P = .017). Technical success was achieved in all patients in both groups. Clinical success was achieved in 25 of 32 (78%) patients in the urgent group vs 113 and 123 (92%) in the elective group (P = .159). The early mortality rate was 13% (4 of 32 patients) in the urgent group vs 1% (1 of 123 patients) in the elective group (P = .120). There was no statistically significant difference regarding the early adverse events between the urgent and elective CP groups. Early aortic-related reinterventions were required in 6 of 32 (19%) patients in the urgent group vs 6 of 123 (5%) in the elective group (P = .094). Thoracic aortic aneurysm sac regression was lower in the urgent group (5/28, 18%, in the urgent group vs 63/114, 55%, in the elective group, P = .001). Stable thoracic aortic aneurysm sac was higher in the urgent group (22/28, 79%, in the urgent group vs 47/114, 41%, in the elective group, P = .000). An increase in thoracic aortic aneurysm sac occurred in 1 of 28 (4%) patients in the urgent group vs 4 of 114 (4%) patients in the elective group (P = .096). Conclusions: The urgent use of the CP technique for distal FL occlusion in aortic dissection was feasible and effective. The decrease in aortic FL sac diameter may be affected by the urgent use of CP due to limited sizing availability. However, it achieved a high rate of aortic remodeling.


Persistent Identifierhttp://hdl.handle.net/10722/353833
ISSN
2023 Impact Factor: 3.9
2023 SCImago Journal Rankings: 1.936

 

DC FieldValueLanguage
dc.contributor.authorEleshra, Ahmed-
dc.contributor.authorKölbel, Tilo-
dc.contributor.authorHaulon, Stephan-
dc.contributor.authorBertoglio, Luca-
dc.contributor.authorRohlffs, Fiona-
dc.contributor.authorDias, Nuno-
dc.contributor.authorPanuccio, Giuseppe-
dc.contributor.authorTsilimparis, Nikolaos-
dc.contributor.authorMougin, Justine-
dc.contributor.authorNyman, Johan-
dc.contributor.authorSonesson, Björn-
dc.contributor.authorFernandez, Carlota-
dc.contributor.authorLindsay, Thomas-
dc.contributor.authorReeps, Christian-
dc.contributor.authorLutz, Brigitta-
dc.contributor.authorTrimarchi, Santi-
dc.contributor.authorLomazzi, Chiara-
dc.contributor.authorSobocinski, Jonothan-
dc.contributor.authorKerezsy, Michael-
dc.contributor.authorvan Rijswijk, Catharina S.P.-
dc.contributor.authorvan Schaik, J.-
dc.contributor.authorPfister, Karin-
dc.contributor.authorMialhe, Claude-
dc.contributor.authorTielliu, Ignace-
dc.contributor.authorModarai, Bijan-
dc.contributor.authorFlorek, Hans Joachim-
dc.contributor.authorJakimowicz, Tomasz-
dc.contributor.authorCheng, Stephen-
dc.contributor.authorChiesa, Roberto-
dc.contributor.authorSalvati, Simone-
dc.date.accessioned2025-01-25T00:35:35Z-
dc.date.available2025-01-25T00:35:35Z-
dc.date.issued2024-07-16-
dc.identifier.citationJournal of Vascular Surgery, 2024, v. 80, n. 5, p. 1418-1424.e1-
dc.identifier.issn0741-5214-
dc.identifier.urihttp://hdl.handle.net/10722/353833-
dc.description.abstract<p>Objective: This study aimed to assess the impact of urgency on early and midterm outcomes of the Candy-Plug (CP) technique for distal false lumen (FL) occlusion in thoracic endovascular aortic repair for aortic dissection. Methods: The CP registry was reviewed, and patients were categorized into elective and urgent/emergent groups for analysis. End points included technical success, clinical success, early (30-day) computed tomography angiography findings, early (30-day) mortality, adverse events, and aortic remodeling in patients with available computed tomography angiography follow-up and reintervention. Results: A total of 155 patients received a custom-made CP, of whom 32 patients (44% male, mean age 61 ± 9 years) were treated urgently and 123 patients (63% male, mean age 62 ± 11 years) electively. The primary CP rate was higher in the urgent group (28/32, 88%, in the urgent group vs 96/123, 78%, in the elective group, P = .051). The mean contrast volume was higher in the urgent group (157 ± 56 mL in the urgent group vs 130 ± 71 mL in the elective group, P = .017). Technical success was achieved in all patients in both groups. Clinical success was achieved in 25 of 32 (78%) patients in the urgent group vs 113 and 123 (92%) in the elective group (P = .159). The early mortality rate was 13% (4 of 32 patients) in the urgent group vs 1% (1 of 123 patients) in the elective group (P = .120). There was no statistically significant difference regarding the early adverse events between the urgent and elective CP groups. Early aortic-related reinterventions were required in 6 of 32 (19%) patients in the urgent group vs 6 of 123 (5%) in the elective group (P = .094). Thoracic aortic aneurysm sac regression was lower in the urgent group (5/28, 18%, in the urgent group vs 63/114, 55%, in the elective group, P = .001). Stable thoracic aortic aneurysm sac was higher in the urgent group (22/28, 79%, in the urgent group vs 47/114, 41%, in the elective group, P = .000). An increase in thoracic aortic aneurysm sac occurred in 1 of 28 (4%) patients in the urgent group vs 4 of 114 (4%) patients in the elective group (P = .096). Conclusions: The urgent use of the CP technique for distal FL occlusion in aortic dissection was feasible and effective. The decrease in aortic FL sac diameter may be affected by the urgent use of CP due to limited sizing availability. However, it achieved a high rate of aortic remodeling.</p>-
dc.languageeng-
dc.publisherElsevier-
dc.relation.ispartofJournal of Vascular Surgery-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.subjectAorta-
dc.subjectAortic dissection-
dc.subjectAortic remodeling-
dc.subjectEmbolization-
dc.subjectEndovascular-
dc.subjectFalse lumen-
dc.subjectRepair-
dc.subjectTEVAR-
dc.titleUrgent Candy-Plug technique for distal false lumen occlusion in chronic aortic dissection-
dc.typeArticle-
dc.identifier.doi10.1016/j.jvs.2024.07.024-
dc.identifier.pmid39029810-
dc.identifier.scopuseid_2-s2.0-85203279061-
dc.identifier.volume80-
dc.identifier.issue5-
dc.identifier.spage1418-
dc.identifier.epage1424.e1-
dc.identifier.eissn1097-6809-
dc.identifier.issnl0741-5214-

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