Addressing persistent false lumen flow in chronic aortic dissection: the knickerbocker technique
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Addressing persistent false lumen flow in chronic aortic dissection: the knickerbocker technique. / Kölbel, Tilo; Carpenter, Sebastian W; Lohrenz, Christina; Tsilimparis, Nikolaos; Larena-Avellaneda, Axel; Debus, Eike Sebastian.
In: J ENDOVASC THER, Vol. 21, No. 1, 02.2014, p. 117-122.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Addressing persistent false lumen flow in chronic aortic dissection: the knickerbocker technique
AU - Kölbel, Tilo
AU - Carpenter, Sebastian W
AU - Lohrenz, Christina
AU - Tsilimparis, Nikolaos
AU - Larena-Avellaneda, Axel
AU - Debus, Eike Sebastian
PY - 2014/2
Y1 - 2014/2
N2 - PURPOSE: To describe an innovative technique to occlude distal backflow into a false lumen aneurysm by controlled rupture of the dissection membrane after stent-graft implantation.TECHNIQUE: The "Knickerbocker technique" involves relining the true lumen in the descending aorta with an oversized thoracic tubular endograft, followed by controlled rupture of the dissection membrane using a large compliant balloon within the graft's midsection. This maneuver, which allows expansion of the stent-graft's midsection into the false lumen, was developed in order to occlude the large false lumen distally and thus prevent continued false lumen perfusion through distal abdominal entry tears. The technique has been successfully used in 3 patients with ruptured or symptomatic chronic false lumen aneurysm in type B aortic dissection. There was no short-term mortality associated with the procedure. After a mean follow-up of 8 months, the false lumen aneurysm remained thrombosed, with no mortality after a mean clinical follow-up of 22 months.CONCLUSION: The Knickerbocker technique appears to be feasible and effective in inducing false lumen thrombosis in selected patients who undergo stent-grafting for chronic type B aortic dissection.
AB - PURPOSE: To describe an innovative technique to occlude distal backflow into a false lumen aneurysm by controlled rupture of the dissection membrane after stent-graft implantation.TECHNIQUE: The "Knickerbocker technique" involves relining the true lumen in the descending aorta with an oversized thoracic tubular endograft, followed by controlled rupture of the dissection membrane using a large compliant balloon within the graft's midsection. This maneuver, which allows expansion of the stent-graft's midsection into the false lumen, was developed in order to occlude the large false lumen distally and thus prevent continued false lumen perfusion through distal abdominal entry tears. The technique has been successfully used in 3 patients with ruptured or symptomatic chronic false lumen aneurysm in type B aortic dissection. There was no short-term mortality associated with the procedure. After a mean follow-up of 8 months, the false lumen aneurysm remained thrombosed, with no mortality after a mean clinical follow-up of 22 months.CONCLUSION: The Knickerbocker technique appears to be feasible and effective in inducing false lumen thrombosis in selected patients who undergo stent-grafting for chronic type B aortic dissection.
KW - Adult
KW - Aged
KW - Aneurysm, Dissecting/diagnosis
KW - Angiography, Digital Subtraction
KW - Aortic Aneurysm, Thoracic/diagnosis
KW - Aortography/methods
KW - Blood Vessel Prosthesis
KW - Blood Vessel Prosthesis Implantation/instrumentation
KW - Chronic Disease
KW - Endovascular Procedures/instrumentation
KW - Female
KW - Humans
KW - Male
KW - Patient Selection
KW - Prosthesis Design
KW - Regional Blood Flow
KW - Stents
KW - Time Factors
KW - Tomography, X-Ray Computed
KW - Treatment Outcome
U2 - 10.1583/13-4463MR-R.1
DO - 10.1583/13-4463MR-R.1
M3 - SCORING: Journal article
C2 - 24502491
VL - 21
SP - 117
EP - 122
JO - J ENDOVASC THER
JF - J ENDOVASC THER
SN - 1526-6028
IS - 1
ER -