TREATMENT OF AORTIC DISSECTIONS USING A COMBINATION OF THE STABILISE AND CERAB TECHNIQUES — TECHNICAL NOTE
Autor(a) principal: | |
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Data de Publicação: | 2019 |
Outros Autores: | , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://doi.org/10.48750/acv.260 |
Resumo: | Introduction: Endovascular treatment of type B aortic dissection has focused on the covering of the proximal entry tear. However, recently, concern has emerged regarding the distal aortic remodeling and new techniques such as the Stent-Assisted Balloon-Induced Intimal Disruption and Relamination (STABILISE) technique have gained more acceptance. We describe a technical note regarding the combination of the STABILISE technique in addition to the Covered Reconstruction of the Aortic Bifurcation (CERAB) technique to achieve complete aortic remodeling. Methods: The authors describe a stepwise approach regarding the endovascular repair of type B aortic dissections. A simple TEVAR is performed first. If the patient still shows signs of true lumen compression, a STABILISE technique is performed in order to achieve true lumen expansion and complete aortic remodeling. However, in some patients, false lumen perfusion and true lumen compression at the very distal aorta is maintained due to distal comunicating tears. In these patients, if there are still signs of infra-renal aortic or iliac compression/occlusion or distal thrombosis of the false lumen, a simultaneous CERAB is performed. Conclusion: By combining these techniques, we aim to cover both the proximal tear and the distal comunicating tears resulting in a complete flap apposition, false lumen obliteration, re-expansion of the true lumen and achieve optimal remodeling. |
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TREATMENT OF AORTIC DISSECTIONS USING A COMBINATION OF THE STABILISE AND CERAB TECHNIQUES — TECHNICAL NOTETRATAMENTO DE DISSECÇÃO DA AORTA UTILIZANDO UMA COMBINAÇÃO DAS TÉCNICAS DE STABILISE E CERAB — NOTA TÉCNICASTABILISECERABaortic dissectionType B aortic dissectionEndovascular repairSTABILISECERABDissecção aórticaDissecção da aorta tipo BReparação endovascularIntroduction: Endovascular treatment of type B aortic dissection has focused on the covering of the proximal entry tear. However, recently, concern has emerged regarding the distal aortic remodeling and new techniques such as the Stent-Assisted Balloon-Induced Intimal Disruption and Relamination (STABILISE) technique have gained more acceptance. We describe a technical note regarding the combination of the STABILISE technique in addition to the Covered Reconstruction of the Aortic Bifurcation (CERAB) technique to achieve complete aortic remodeling. Methods: The authors describe a stepwise approach regarding the endovascular repair of type B aortic dissections. A simple TEVAR is performed first. If the patient still shows signs of true lumen compression, a STABILISE technique is performed in order to achieve true lumen expansion and complete aortic remodeling. However, in some patients, false lumen perfusion and true lumen compression at the very distal aorta is maintained due to distal comunicating tears. In these patients, if there are still signs of infra-renal aortic or iliac compression/occlusion or distal thrombosis of the false lumen, a simultaneous CERAB is performed. Conclusion: By combining these techniques, we aim to cover both the proximal tear and the distal comunicating tears resulting in a complete flap apposition, false lumen obliteration, re-expansion of the true lumen and achieve optimal remodeling.Introdução: O tratamento endovascular de dissecções tipo B tem-se focado na cobertura da porta de entrada. No entanto, recentemente, tem surgido a preocupação em relação ao remodeling distal da aorta e novas técnicas como a Stent-Assisted Balloon-Induced Intimal Disruption and Relamination (STABILISE) tem ganho relevo.Os autores descrevem um nota técnica de uma combinação da técnica de STABILISE com a Covered Reconstruction of the Aortic Bifurcation (CERAB) de forma a obter um remodeling aórtico completo. Métodos: Neste artigo descreve-se uma abordagem sequencial no tratamento endovascular de dissecções da aorta tipo B. O procedimento é iniciado com um TEVAR simples. Se o doente mantém sinais de compressão do verdadeiro lúmen após a abertura da primeira endoprótese a técnica de STABILISE é realizada sempre que possível de forma a obter expansão do verdadeiro lúmen e remodeling aórtico completo. No entanto, em alguns doentes, a perfusão do falso e compressão do verdadeiro lúmen mantêm-se devido a portas de re-entrada distais. Nestes doentes, se existirem sinais de oclusão da aorta infra-renal ou iliaca ou ainda a presença de trombose distal do falso lúmen a ténica de CERAB é realizada em simultâneo. Conclusão: A combinação de ambas as técnicas com o objetivo de cobrir a porta de entrada e as portas de re-entrada distais permite uma união de ambos os flaps, com obliteração completa do falso lúmen, expansão do verdadeiro lúmen e um remodeling aórtico óptimo.Sociedade Portuguesa de Angiologia e Cirurgia Vascular2019-12-27T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttps://doi.org/10.48750/acv.260oai:ojs.acvjournal.com:article/260Angiologia e Cirurgia Vascular; Vol. 15 No. 3 (2019): September; 200-205Angiologia e Cirurgia Vascular; Vol. 15 N.º 3 (2019): Setembro; 200-2052183-00961646-706Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPenghttp://acvjournal.com/index.php/acv/article/view/260https://doi.org/10.48750/acv.260http://acvjournal.com/index.php/acv/article/view/260/151Copyright (c) 2019 Angiologia e Cirurgia Vascularinfo:eu-repo/semantics/openAccessGouveia e Melo, RyanFernandes e Fernandes, RuyGarrido, PedroLopes, AliceRato, João PedroLeitão, JoãoPedro, Luís Mendes2022-05-23T15:10:07Zoai:ojs.acvjournal.com:article/260Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T14:57:38.392548Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
TREATMENT OF AORTIC DISSECTIONS USING A COMBINATION OF THE STABILISE AND CERAB TECHNIQUES — TECHNICAL NOTE TRATAMENTO DE DISSECÇÃO DA AORTA UTILIZANDO UMA COMBINAÇÃO DAS TÉCNICAS DE STABILISE E CERAB — NOTA TÉCNICA |
title |
TREATMENT OF AORTIC DISSECTIONS USING A COMBINATION OF THE STABILISE AND CERAB TECHNIQUES — TECHNICAL NOTE |
spellingShingle |
TREATMENT OF AORTIC DISSECTIONS USING A COMBINATION OF THE STABILISE AND CERAB TECHNIQUES — TECHNICAL NOTE Gouveia e Melo, Ryan STABILISE CERAB aortic dissection Type B aortic dissection Endovascular repair STABILISE CERAB Dissecção aórtica Dissecção da aorta tipo B Reparação endovascular |
title_short |
TREATMENT OF AORTIC DISSECTIONS USING A COMBINATION OF THE STABILISE AND CERAB TECHNIQUES — TECHNICAL NOTE |
title_full |
TREATMENT OF AORTIC DISSECTIONS USING A COMBINATION OF THE STABILISE AND CERAB TECHNIQUES — TECHNICAL NOTE |
title_fullStr |
TREATMENT OF AORTIC DISSECTIONS USING A COMBINATION OF THE STABILISE AND CERAB TECHNIQUES — TECHNICAL NOTE |
title_full_unstemmed |
TREATMENT OF AORTIC DISSECTIONS USING A COMBINATION OF THE STABILISE AND CERAB TECHNIQUES — TECHNICAL NOTE |
title_sort |
TREATMENT OF AORTIC DISSECTIONS USING A COMBINATION OF THE STABILISE AND CERAB TECHNIQUES — TECHNICAL NOTE |
author |
Gouveia e Melo, Ryan |
author_facet |
Gouveia e Melo, Ryan Fernandes e Fernandes, Ruy Garrido, Pedro Lopes, Alice Rato, João Pedro Leitão, João Pedro, Luís Mendes |
author_role |
author |
author2 |
Fernandes e Fernandes, Ruy Garrido, Pedro Lopes, Alice Rato, João Pedro Leitão, João Pedro, Luís Mendes |
author2_role |
author author author author author author |
dc.contributor.author.fl_str_mv |
Gouveia e Melo, Ryan Fernandes e Fernandes, Ruy Garrido, Pedro Lopes, Alice Rato, João Pedro Leitão, João Pedro, Luís Mendes |
dc.subject.por.fl_str_mv |
STABILISE CERAB aortic dissection Type B aortic dissection Endovascular repair STABILISE CERAB Dissecção aórtica Dissecção da aorta tipo B Reparação endovascular |
topic |
STABILISE CERAB aortic dissection Type B aortic dissection Endovascular repair STABILISE CERAB Dissecção aórtica Dissecção da aorta tipo B Reparação endovascular |
description |
Introduction: Endovascular treatment of type B aortic dissection has focused on the covering of the proximal entry tear. However, recently, concern has emerged regarding the distal aortic remodeling and new techniques such as the Stent-Assisted Balloon-Induced Intimal Disruption and Relamination (STABILISE) technique have gained more acceptance. We describe a technical note regarding the combination of the STABILISE technique in addition to the Covered Reconstruction of the Aortic Bifurcation (CERAB) technique to achieve complete aortic remodeling. Methods: The authors describe a stepwise approach regarding the endovascular repair of type B aortic dissections. A simple TEVAR is performed first. If the patient still shows signs of true lumen compression, a STABILISE technique is performed in order to achieve true lumen expansion and complete aortic remodeling. However, in some patients, false lumen perfusion and true lumen compression at the very distal aorta is maintained due to distal comunicating tears. In these patients, if there are still signs of infra-renal aortic or iliac compression/occlusion or distal thrombosis of the false lumen, a simultaneous CERAB is performed. Conclusion: By combining these techniques, we aim to cover both the proximal tear and the distal comunicating tears resulting in a complete flap apposition, false lumen obliteration, re-expansion of the true lumen and achieve optimal remodeling. |
publishDate |
2019 |
dc.date.none.fl_str_mv |
2019-12-27T00:00:00Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://doi.org/10.48750/acv.260 oai:ojs.acvjournal.com:article/260 |
url |
https://doi.org/10.48750/acv.260 |
identifier_str_mv |
oai:ojs.acvjournal.com:article/260 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
http://acvjournal.com/index.php/acv/article/view/260 https://doi.org/10.48750/acv.260 http://acvjournal.com/index.php/acv/article/view/260/151 |
dc.rights.driver.fl_str_mv |
Copyright (c) 2019 Angiologia e Cirurgia Vascular info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Copyright (c) 2019 Angiologia e Cirurgia Vascular |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Sociedade Portuguesa de Angiologia e Cirurgia Vascular |
publisher.none.fl_str_mv |
Sociedade Portuguesa de Angiologia e Cirurgia Vascular |
dc.source.none.fl_str_mv |
Angiologia e Cirurgia Vascular; Vol. 15 No. 3 (2019): September; 200-205 Angiologia e Cirurgia Vascular; Vol. 15 N.º 3 (2019): Setembro; 200-205 2183-0096 1646-706X reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
instname_str |
Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
instacron_str |
RCAAP |
institution |
RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
collection |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
repository.name.fl_str_mv |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
repository.mail.fl_str_mv |
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1799129849732792320 |