The Candy-Plug Technique: Technical Aspects and Early Results of a New Endovascular Method for False Lumen Occlusion in Chronic Aortic Dissection

TY - JOUR

T1 - The Candy-Plug Technique: Technical Aspects and Early Results of a New Endovascular Method for False Lumen Occlusion in Chronic Aortic Dissection

AU - Rohlffs, Fiona

AU - Tsilimparis, Nikolaos

AU - Fiorucci, Beatrice

AU - Heidemann, Franziska

AU - Debus, Eike Sebastian

AU - Kölbel, Tilo

PY - 2017/8

Y1 - 2017/8

N2 - PURPOSE: To describe the technical aspects and early results of the Candy-Plug technique for endovascular false lumen occlusion in chronic aortic dissection.METHODS: A retrospective single-center study analyzing 18 consecutive patients (mean age 63 years, range 44-76; 16 men) with thoracic false lumen aneurysm in chronic aortic dissection. All patients underwent thoracic endovascular aortic repair with false lumen occlusion using the Candy-Plug technique. Primary endpoints consisted of technical success (successful deployment) and clinical success (no false lumen backflow). Secondary endpoints included 30-day mortality and morbidity as well as aortic remodeling during follow-up.RESULTS: Technical success was 100%. Additional intraprocedural false lumen embolization at the Candy-Plug level was needed in 1 patient due to persisting false lumen backflow on the final angiogram (clinical success 94%). There were no intraprocedural complications. In the perioperative period, there were 3 minor complications: transient mild spinal cord ischemia, cervical hematoma after carotid-subclavian bypass, and a common femoral artery pseudoaneurysm. No deaths or reinterventions occurred. Complete distal false lumen occlusion was present on postoperative computed tomography in 15 patients, while 3 had minor contrast enhancement in the distal false lumen. Over a mean 9-month follow-up (range 0-26), 1 patient died due to rupture. Follow-up >6 months was available in 10 patients (mean 14.7 months, range 7-26): 7 patients showed aortic remodeling, while aneurysm size was stable in 3 patients.CONCLUSION: The Candy-Plug technique is a feasible endovascular method to achieve false lumen occlusion and aortic remodeling in chronic aortic dissection. It is associated with low morbidity and mortality due to its minimal invasiveness.

AB - PURPOSE: To describe the technical aspects and early results of the Candy-Plug technique for endovascular false lumen occlusion in chronic aortic dissection.METHODS: A retrospective single-center study analyzing 18 consecutive patients (mean age 63 years, range 44-76; 16 men) with thoracic false lumen aneurysm in chronic aortic dissection. All patients underwent thoracic endovascular aortic repair with false lumen occlusion using the Candy-Plug technique. Primary endpoints consisted of technical success (successful deployment) and clinical success (no false lumen backflow). Secondary endpoints included 30-day mortality and morbidity as well as aortic remodeling during follow-up.RESULTS: Technical success was 100%. Additional intraprocedural false lumen embolization at the Candy-Plug level was needed in 1 patient due to persisting false lumen backflow on the final angiogram (clinical success 94%). There were no intraprocedural complications. In the perioperative period, there were 3 minor complications: transient mild spinal cord ischemia, cervical hematoma after carotid-subclavian bypass, and a common femoral artery pseudoaneurysm. No deaths or reinterventions occurred. Complete distal false lumen occlusion was present on postoperative computed tomography in 15 patients, while 3 had minor contrast enhancement in the distal false lumen. Over a mean 9-month follow-up (range 0-26), 1 patient died due to rupture. Follow-up >6 months was available in 10 patients (mean 14.7 months, range 7-26): 7 patients showed aortic remodeling, while aneurysm size was stable in 3 patients.CONCLUSION: The Candy-Plug technique is a feasible endovascular method to achieve false lumen occlusion and aortic remodeling in chronic aortic dissection. It is associated with low morbidity and mortality due to its minimal invasiveness.

KW - Adult

KW - Aged

KW - Aneurysm, Dissecting/diagnostic imaging

KW - Aortic Aneurysm, Thoracic/diagnostic imaging

KW - Blood Vessel Prosthesis

KW - Blood Vessel Prosthesis Implantation/adverse effects

KW - Chronic Disease

KW - Endovascular Procedures/adverse effects

KW - Female

KW - Humans

KW - Male

KW - Middle Aged

KW - Prosthesis Design

KW - Retrospective Studies

KW - Time Factors

KW - Treatment Outcome

KW - Ventricular Remodeling

U2 - 10.1177/1526602817709252

DO - 10.1177/1526602817709252

M3 - SCORING: Journal article

C2 - 28490232

VL - 24

SP - 549

EP - 555

JO - J ENDOVASC THER

JF - J ENDOVASC THER

SN - 1526-6028

IS - 4

ER -