Custom Made Candy Plug for Distal False Lumen Occlusion in Aortic Dissection: International Experience
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Custom Made Candy Plug for Distal False Lumen Occlusion in Aortic Dissection: International Experience. / Eleshra, Ahmed; Haulon, Stephan; Bertoglio, Luca; Lindsay, Thomas; Rohlffs, Fiona; Dias, Nuno; Tsilimparis, Nikolaos; Panuccio, Giuseppe; Kölbel, Tilo; Candy-Plug Collaborators.
In: EUR J VASC ENDOVASC, Vol. 66, No. 1, 07.2023, p. 50-56.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Custom Made Candy Plug for Distal False Lumen Occlusion in Aortic Dissection: International Experience
AU - Eleshra, Ahmed
AU - Haulon, Stephan
AU - Bertoglio, Luca
AU - Lindsay, Thomas
AU - Rohlffs, Fiona
AU - Dias, Nuno
AU - Tsilimparis, Nikolaos
AU - Panuccio, Giuseppe
AU - Kölbel, Tilo
AU - Candy-Plug Collaborators
N1 - Copyright © 2023 European Society for Vascular Surgery. Published by Elsevier B.V. All rights reserved.
PY - 2023/7
Y1 - 2023/7
N2 - OBJECTIVE: To evaluate early and midterm outcomes of the Candy Plug (CP) technique for distal false lumen (FL) occlusion in thoracic endovascular aortic repair for aortic dissection (AD) in a more real world cohort of patients from an international multicentre registry.METHODS: A multicentre retrospective study was conducted of all consecutive patients from the contributing centres with subacute and chronic AD treated with the CP technique from October 2013 to April 2020 at 18 centres.RESULTS: A custom made CP was used in 155 patients (92 males, mean age 62 ± 11 years). Fourteen (9%) presented with ruptured false lumen aneurysms. Technical success was achieved in all patients (100%). Clinical success was achieved in 138 patients (89%). The median hospital stay was 7 days (1 - 77). The 30 day mortality rate was 3% (n = 5). Stroke occurred in four patients (3%). Spinal cord ischaemia occurred in three patients (2%). The 30 day computed tomography angiogram (CTA) confirmed successful CP placement at the intended level in all patients. Early complete FL occlusion was achieved in 120 patients (77%). Early (30 day) CP related re-intervention was required in four patients (3%). The early (30 day) stent graft related re-intervention rate was 8% (n = 12). Follow up CTA was available in 142 patients (92%), with a median follow up of 23 months (6 - 87). Aneurysmal regression was achieved in 68 of 142 patients (47%); the aneurysm diameter remained stable in 69 of 142 patients (49%) and increased in five of 142 patients (4%). A higher rate of early FL occlusion was detected in the largest volume centre patients (50 [88%] vs. 70 [71%] from other centres; p = .019). No other differences in outcome were identified regarding volume of cases or learning curve.CONCLUSION: This international CP technique experience confirmed its feasibility and low mortality and morbidity rates. Aortic remodelling and false lumen thrombosis rates were high and support the concept of distal FL occlusion in AD using the CP technique.
AB - OBJECTIVE: To evaluate early and midterm outcomes of the Candy Plug (CP) technique for distal false lumen (FL) occlusion in thoracic endovascular aortic repair for aortic dissection (AD) in a more real world cohort of patients from an international multicentre registry.METHODS: A multicentre retrospective study was conducted of all consecutive patients from the contributing centres with subacute and chronic AD treated with the CP technique from October 2013 to April 2020 at 18 centres.RESULTS: A custom made CP was used in 155 patients (92 males, mean age 62 ± 11 years). Fourteen (9%) presented with ruptured false lumen aneurysms. Technical success was achieved in all patients (100%). Clinical success was achieved in 138 patients (89%). The median hospital stay was 7 days (1 - 77). The 30 day mortality rate was 3% (n = 5). Stroke occurred in four patients (3%). Spinal cord ischaemia occurred in three patients (2%). The 30 day computed tomography angiogram (CTA) confirmed successful CP placement at the intended level in all patients. Early complete FL occlusion was achieved in 120 patients (77%). Early (30 day) CP related re-intervention was required in four patients (3%). The early (30 day) stent graft related re-intervention rate was 8% (n = 12). Follow up CTA was available in 142 patients (92%), with a median follow up of 23 months (6 - 87). Aneurysmal regression was achieved in 68 of 142 patients (47%); the aneurysm diameter remained stable in 69 of 142 patients (49%) and increased in five of 142 patients (4%). A higher rate of early FL occlusion was detected in the largest volume centre patients (50 [88%] vs. 70 [71%] from other centres; p = .019). No other differences in outcome were identified regarding volume of cases or learning curve.CONCLUSION: This international CP technique experience confirmed its feasibility and low mortality and morbidity rates. Aortic remodelling and false lumen thrombosis rates were high and support the concept of distal FL occlusion in AD using the CP technique.
KW - Male
KW - Humans
KW - Middle Aged
KW - Aged
KW - Aortic Aneurysm, Thoracic/diagnostic imaging
KW - Blood Vessel Prosthesis Implantation/methods
KW - Retrospective Studies
KW - Aortic Dissection/diagnostic imaging
KW - Stents
KW - Aneurysm, False/surgery
KW - Endovascular Procedures/methods
KW - Aortography/methods
KW - Treatment Outcome
KW - Blood Vessel Prosthesis
U2 - 10.1016/j.ejvs.2023.03.020
DO - 10.1016/j.ejvs.2023.03.020
M3 - SCORING: Journal article
C2 - 36958480
VL - 66
SP - 50
EP - 56
JO - EUR J VASC ENDOVASC
JF - EUR J VASC ENDOVASC
SN - 1078-5884
IS - 1
ER -
