Treatment of Residual Type A Aortic Dissection With Implantation of the Djumbodis System: Is Purely Endovascular Treatment Becoming a Reality?

Abstract

Purpose

To evaluate the usefulness of a new transfemoral device to avoid major complications related to residual type A aortic dissection following ascending aortic replacement.

Case Reports

Three men (aged 60, 61, and 72 years, respectively) with a residual type A aortic dissection following replacement of the ascending aorta 1, 4, and 5 years prior, respectively, were treated with the Djumbodis Dissection System. The residual dissection developed at the distal anastomosis of the aortic graft and involved all the aortic arch. The Djumbodis Dissection System is an uncovered steel stent, available in 3 lengths (40, 90, 140 mm), pre-mounted on a low pressure (0.3 bars) balloon catheter. The mesh of the device is sufficiently large to bring together the dissected layers without occluding main vital branches. The device was implanted through the femoral artery over a stiff guidewire to exclude the residual false lumen. Satisfactory aortic remodeling was documented in all cases at 1 year.

Conclusion

The Djumbodis Dissection System might be a purely endovascular treatment to replace open surgery for residual type A aortic dissection. More cases and longer follow-up are required.

Keywords

thoracic aorta aortic arch dissection false lumen ascending aortic graft stent residual dissection type A dissection

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