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Thoracic stent graft linked with positive outcomes in patients with acute aortic dissection
LAS VEGAS — Patients with acute type B aortic dissection benefited from treatment with a thoracic stent graft, according to midterm findings of the DISSECTION trial presented at VIVA 15.
Researchers enrolled 50 patients with acute type B aortic dissection and malperfusion or contained rupture in the prospective, nonrandomized pivotal trial. All received endovascular aortic repair with the thoracic stent graft (Valiant Captivia, Medtronic). Follow-up is planned to 5 years.
Ali Azizzadeh
Ali Azizzadeh, MD, from Memorial Hermann Heart and Vascular Institute, Houston, reported 2-year results of the 35 patients available for follow-up here.
Between 1 and 2 years, there was one death, which was attributed to natural causes. No device-related adverse events were reported, Azizzadeh said during a press conference.
He also reported that there were no post-index procedure ruptures or conversions to open surgery. Also, between 1 year and 2 years, no open repairs of retrograde type A aortic dissections were required and one patient experienced at least one serious adverse event.
One patient needed to undergo three additional endovascular procedures to treat perfusion of the false lumen, he said.
There were no cases of loss of integrity or stent graft collapse, according to Azizzadeh.
At 2 years, freedom from all-cause mortality was 81.8% and freedom from dissection-related mortality was 90%.
True lumen diameter stabilized or increased the stented area in 85.7% of patients and false-lumen diameter remained stable or decreased in 78.6% of patients at 2 years, while the false lumen was thrombosed completely or partially in 70.4% of patients, he said.
“The Valiant Captivia has demonstrated positive outcomes at 2 years for acute complicated capillary dissection,” Azizzadeh said. ˗ by Erik Swain
Reference:
Azizzadeh A, et al. Late-Breaking Clinical Trials. Presented at: VIVA 15; Nov. 2-5, 2015; Las Vegas.
Disclosure: The study was funded by Medtronic. Azizzadeh reports receiving research funding from, consulting for and receiving honoraria from Gore and Medtronic.
Perspective
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The data from the DISSECTION trial were very good. They support data that have already been established for other devices showing that the endovascular approach to treating dissection does better than surgery in many cases.