Ascyrus Medical Dissection Stent In the treatment of acute type A Aortic
dissection. A First-Hand Experience
Abstract
Background: Acute type A aortic dissection is associated with a
significant perioperative morbidity and mortality. Ascyrus Medical
Dissection Stent (AMDS) is a novel bare stent graft developed to be used
as an adjunct to standard surgical approach to promote true lumen
expansion and therefor enhance aortic remodeling. Patients and
Methods: From March 2021 to March 2022, four consecutive patients who
presented with acute Debakey type I aortic dissection underwent emergent
surgical repair with an inclusion (David) procedure and implantation of
an AMDS. We analysed patient’s files prospectively and described the
perioperative outcomes. Results: All four device implantations
were successful. Overall 30-day mortality was 0 %. Malperfusion that
was present in two patients pre-operatively improved after AMDS
implantation. At follow up, no aortic reinterventions were needed. No
aortic injury related to the device was noted. Favourable changes in
aortic true lumen and false lumen dimensions were found in most of our
patients but the AMDS was compressed at the isthmus in one patient.
Conclusion: AMDS is a reliable and secure device. However, its
benefits remain unclear when it comes to a positive remodeling and seems
less likelihood comparable to a frozen elephant trunk. The main reason
seems to be an insufficient radial force of the AMDS.