PMC6383177_01
I. Pre-operative computed tomography angiography of a "subacute" type A aortic dissection. Axial scans with the true (*) and false (**) lumens at the level of the descending thoracic aorta (A), thoraco-abdominal junction (B), celiac trunk (C), superior mesenteric artery (D), and renal arteries (E). II. Computed tomography angiography after STABILISE procedure at the same levels with complete remodelling of the thoraco-abdominal aorta.
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TL at lower descending thoracic aorta level (Fig. 1). There was no overt organ ischaemia.
Ascending aorta and arch replacement using a hybrid stent graft system, over a previously inserted stiff wire, thus allowing the creation of a "frozen elephant trunk" and a proximal landing zone for the endovascular stage (A and B); aortic dissection (C).
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PMC6383177_02
I. Pre-operative computed tomography angiography of a chronic type B aortic dissection. Axial scans with the true (*) and false (**) lumens at the level of the descending thoracic aorta (A), thoraco-abdominal junction (B), celiac trunk (C), superior mesenteric artery (D), and renal arteries (E). II. CTA after STABILISE procedure at the same levels with complete remodelling of the thoraco-abdominal aorta.
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Four months after the initial event he reported severe bilateral lower limb claudication which was attributed to the extreme compression of the TL by the FL in the visceral segment although no evidence of visceral malperfusion was present (Fig. 4). The completion angiogram and the post-operative CTA confirmed the complete realignment of the aorta with TL patency, FL obliteration, and patency of all aortic branches (Figure 4, Figure 6).
Sequential ballooning of the bare metal stent in a caudal direction with progressive expansion of the stent and consequent reapposition of the flap to the outer aortic wall.
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Finally, a 46 mm Coda balloon (Cook Medical) was used to sequentially dilate (craniocaudal direction) the stent grafts and the dissection stent aiming to obliterate the FL (Fig. 5).
Post-operative computed tomography angiography of a chronic type B aortic dissection showing a patent left vertebral artery reimplanted in the left common carotid artery.
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The completion angiogram and the post-operative CTA confirmed the complete realignment of the aorta with TL patency, FL obliteration, and patency of all aortic branches (Figure 4, Figure 6).