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Total Percutaneous Transfemoral Endovascular Treatment of Non-A Non-B Aortic Dissection.

JACC Case Rep

January 2025

Chinese Institutes for Medical Research and Anzhen Hospital, Capital Medical University, Beijing, China.

Although open repair remains the mainstream treatment for aortic arch dissection, its surgical complexity and perioperative complications are significant. We developed a novel stentgraft system for less-invasive endovascular aortic arch repair. We successfully performed a total percutaneous transfemoral endovascular repair of aortic arch dissection using a novel off-the-shelf endograft system.

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Non-A non-B aortic dissection is considered a rare nosological entity, included in the Stanford classification, representing a small percentage of the total aortic dissections that occur annually. Regarding this form, the literature reports a more complicated disease course compared to other types of dissection. We describe the case of a 76-year-old patient who accessed the triage section of an emergency department for a polytrauma picture and, after surgical treatment of a leg fracture, received a diagnosis of non-A non-B aortic dissection, "localized" to the arch and incidentally detected.

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Objective: Acute aortic dissection remains a serious emergency in the field of cardiovascular medicine and a challenge for cardiothoracic surgeons. In the present study, we seek to compare the outcomes of different surgical techniques in the repair of type A acute aortic dissection.

Methods: Between April 2015 and May 2023, 213 patients (82 women, aged: 63.

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Article Synopsis
  • The study aimed to improve aortic arch replacement efficiency using a new frozen elephant trunk (FET) prosthesis designed for better connection to the left subclavian artery (LSA).
  • Four patients underwent surgery with this customized device, and all were discharged in good condition after the procedure.
  • While the initial results are promising, highlighting the potential of the new prosthesis, further clinical studies are needed to analyze its effectiveness and optimize design parameters.
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