![]() The study was approved by the institutional review board at our institution and informed consent was waived. The purpose of this study is to characterize endovascular adjuncts used to obliterate the false lumen of chronic aortic dissections and present updated outcomes in a recent series of patients undergoing FLE for chronic aortic dissection. Over the last decade, patient selection and surgical techniques have evolved. Various endovascular techniques to treat persistent false lumen perfusion including false lumen embolization (FLE) have been previously described. While open thoracoabdominal aortic repair may be durable, it also carries with it significant morbidity and mortality ( 11- 13). In chronic thoracoabdominal aortic dissections the false lumen is often still pressurized by retrograde false lumen flow alongside the stented true lumen of the aorta from distal re-entry tears and branches off the false lumen in the abdominal aorta ( 10). Conversely, thrombosis of the false lumen is an independent predictor of aortic positive remodeling ( 8, 9). Continued false lumen patency results in aneurysmal degeneration and risk of aortic rupture requiring additional reinterventions ( 4- 7). Though proximal entry tears in the thoracic aorta may be covered by endografts, total thrombosis of the false lumen is achieved only in a minority of patients ( 3). Thoracic endovascular aortic repair (TEVAR) has become an integral and well tolerated intervention for thoracoabdominal aortic dissection, but persistent false lumen patency represents a mode of treatment failure and is associated with poor long-term outcomes ( 1, 2). Keywords: Aortic dissection endovascular false lumen embolization aneurysm No patients underwent subsequent open surgical repair.Ĭonclusions: TEVAR with adjunctive false lumen embolization and balloon fracture fenestration are techniques to obliterate retrograde flow into the false lumen of chronic thoracoabdominal aortic dissections in appropriately selected patients. There was 1 (5.9%) patient that required endovascular re-intervention on the thoracoabdominal aorta. No patients required dialysis, though 1 (5.9%) did experience acute kidney injury. Results: After false lumen embolization there was no mortality, stroke, spinal cord ischemia, or visceral and limb ischemia. This was often in conjunction with or following TEVAR and balloon fracture fenestration. Methods: From January 2018 to May 2021, 17 patients with chronic dissection underwent false lumen embolization with coils, iliac plugs, and nitinol plugs. Objectives of this study are to describe endovascular techniques to obliterate the false lumen and present updated outcomes in a recent series of patients undergoing false lumen embolization for chronic aortic dissection. We have previously described the evolution of various endovascular techniques to treat persistent false lumen perfusion including false lumen embolization. Background: Persistent false lumen patency in chronic thoracoabdominal aortic dissections after thoracic endovascular aortic repair (TEVAR) contributes to negative aortic remodeling.
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