Bare Metal Stent Use in Type B Aortic Dissection May Offer Positive Remodeling for the Distal Aorta

Abstract

The use of a PETTICOAT concept with an addition of a bare metal stent distal to the proximal thoracic endograft offers positive aortic remodeling in the thoracoabdominal aorta at 6 months.

Endovascular repair of a dissecting pararenal abdominal aortic aneurysm in a patient with type III Loeys-Dietz syndrome

“…Non-covered endovascular dissection stents have been described to address infrarenal dissection but would have been inadequate in this patient due to the zone 9/10 fenestrations necessitating a covered stent. 19 Further support for the more liberal use of endovascular platforms in patients with LDS-3-related vascular pathology was provided by Van der Linde and colleagues who described 6 LDS-3 patients who underwent visceral/iliac procedures, noting "tissue handling felt the same as in patients without a connective tissue disorder; thus, elective interventions seem to be feasible and safe in AOS patients so far." 20 They encouraged visceral stenting in LDS-3.…”

“…Clinical Features 1, 7,8,19,22 Type 1 TGFβR1 Arterial aneurysms, aortic root dilation, early aortic dissection, and vascular tortuosity with facial dysmorphic features (hypertelorism, bifid uvula, cleft palate) Type 2 TGFβR2 Arterial aneurysms, aortic root dilation, early aortic dissection, and vascular tortuosity with cutaneous features (atrophic scarring, visible veins, poor wound healing) Type 3 SMAD3 Arterial aneurysms, aortic root dilation, and vascular tortuosity with bone and sometimes joint pathology (osteoarthritis, osteochondritis dessicans) Type 4…”

Commentary: Should we use a “full metal jacket” after repair for chronic residual type I aortic dissection?

“…Furthermore, thoracic endovascular aortic repair in acute type B dissection showed significant positive aortic remodeling in the thoracic aorta; remodeling improved by the adjunct of the Petticoat technique, although the mid-to long-term benefit of the Petticoat technique still needs to be proven in the setting of acute aortic dissection. 2,3 With the development of frozen elephant trunk and hybrid arch debranching techniques, new strategies emerged to treat residual chronic type I aortic dissection with less morbidity and mortality. However, a significant proportion of patients remained with significant thoracic FL perfusion and aortic expansion.…”

Modeling Approach for An Aortic Dissection with Endovascular Stenting

“…Although the conventional endovascular approaches with stent-grafts are performed less invasively, there is a limitation of installation at the branching sites. [1][2][3][4][5] The purpose of this study was to examine an aortic bare-metal stent which was capable of installing to the aortic dissected lesion for biomedical hemodynamics point of view.…”