Long-Term Volumetric Evaluation of Stent-Assisted Balloon-Induced Intimal Disruption and Relamination of Aortic Dissection (STABILISE) in Acute Type B Aortic Dissection

Abstract

ObjectiveTo quantify the volumetric aortic remodeling of patients with acute type B aortic dissection (ATBAD) treated with the stent-assisted balloon-induced intimal disruption and relamination (STABILISE) technique. MethodsAll patients with ATBAD operated with the STABILISE technique between 2014 and 2017 with pre-operative (PreOp), post-operative (PostOp) and >12 months (follow-up) computed tomography scans were included in this study. True lumen and total aortic volume were accurately assessed in the thoracic and abdominal portions with a semi-automatic 3D tool. Associations with long-term adverse events were estimated. ResultsSeventeen patients were measured at PreOp, PostOp and a mean follow-up of 19±8 months. The false lumen to total volume ratio decreased on average from 63% to 18% after STABILISE (p<0.001) and remained around 12% at follow-up. These remodeling was more pronounced in the thoracic aorta (7%) than in the abdominal aorta (28%). The trend in aortic size growth was stronger for volumes than for maximum areas or diameters (p<0.001, p<0.05 and p<0.05, respectively). Adverse events were identified in 4 patients during a long-term follow-up of 76±18 months. The only aortic size variable assessed preoperatively that was associated with undesirable events was the total volume of the abdominal aorta (p<0.05). ConclusionsA volumetric analysis of dissected aortic size after the STABILISE procedure allowed accurate quantification of mid-term aortic remodeling and helped to identify the abdominal aortic volume as a preoperative variable associated with undesirable long-term events.