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Table 1 Summary of treatment strategies of PDAA

From: Endovascular strategies for post-dissection aortic aneurysm (PDAA)

 

Advantages

Disadvantages

Trans-TL Repair

 TEVAR

•Exclude tears above the celiac trunk

•Reduce flow and pressure of the FL

•unable to exclude the entry tears in visceral artery segment of abdominal aorta

•Distal residual tears may result in negative remodeling

 PETTICOAT

•Expand distal TL

•Stabilization of dissecting initial flap

•Effective in non-chronic AD

•The risk aneurysm formation

•Distal residual tears untreated

 STABILISE and Knickbocker

•Create a single lumen to block distal backflow

•The risk of aortic rupture

 Parallel stent-graft technique

•Flexible combination

•Suitable for a variety of anatomy

•Suitable for emergency and selective operation

•Endoleak

•Recurrent aortic dissection

•Chimney stent occlusion

•Cost expensive

 Branched and fenestrated stent-graft

•Suitable for uncomplicated anatomical conditions

•Widely used in PDAA

•Difficult in TL stenosis cases

•Difficult in reconstruction of visceral artery totally originated from FL.

 MBS/MFM

•Restores flow perfusion

•Decompress the FL

•Visceral artery ischemia

•Difficulty in re-intervention

Trans-FL Repair

 FL embolization

•Avoid excessive coverage of the TL of aorta

•Reduces the risk of spinal cord ischemia

•A complementary and auxiliary therapeutic measure

•No special devices for FL embolism

 Candy plug

•Promote the thoracic aorta segment aortic remodeling

•No effect for abdominal FL

•The potential risk of aortic rupture

  1. PDAA Post-dissection aortic aneurysm, TL True lumen, TEVAR Thoracic endovascular aortic repair, FL False lumen, PETTICOAT Provisional extension to induce complete attachment, AD Aortic dissection, STABILISE Stent-assisted balloon-induced intimal disruption and relamination in aortic dissection repair, MBS/MFM Multilayer bare stents/multilayer flow modulator