{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T13:23:12Z","timestamp":1762867392079,"version":"3.37.3"},"reference-count":35,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2018,3,30]],"date-time":"2018-03-30T00:00:00Z","timestamp":1522368000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100005081","name":"Beijing Council of Science and Technology","doi-asserted-by":"publisher","award":["Z171100000417021","Z171100001017214"],"award-info":[{"award-number":["Z171100000417021","Z171100001017214"]}],"id":[{"id":"10.13039\/501100005081","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2018,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Thoracic endovascular aortic repair (TEVAR) has changed the management of aortic dissection by induced remodelling. Beyond reconstructing the true lumen, we describe the concept of False Lumen Intervention to promote Remodelling and Thrombosis (FLIRT) in both type A and B aortic dissection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Between 2011 and 2017, 10 patients with aortic dissection (5 type A; 5 type B) underwent FLIRT using a combination of patent foramen ovale (PFO) or atrial septal defect (ASD) occluders, coils and glue. Patients were followed by computed tomography (CT) angiogram prior to, and 6 months following, discharge to evaluate false lumen (FL) thrombosis and aortic remodelling. Outcomes analyzed comprised successful device delivery, completeness of FL thrombosis and aortic remodelling, procedure related complications and mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>FLIRT induced aortic remodelling in all cases of proximal dissection, with aortic shrinkage from 63.8\u2009\u00b1\u20097.5 pre\u2010FLIRT, to 50.2\u2009\u00b1\u20096.6 mm (<jats:italic>P<\/jats:italic>\u2009=\u20090.057) and an increase in true lumen area from 5.8\u2009\u00b1\u20093.6 to 11.4\u2009\u00b1\u20092.5 cm<jats:sup>2<\/jats:sup> (<jats:italic>P<\/jats:italic>\u2009=\u20090.006). In distal dissection (after previous TEVAR with residual FL flow), FLIRT successfully induced FL thrombosis in 4 of 5 cases at first attempt (1 case required additional coiling of the gutter between left subclavian artery and stent\u2010graft for complete thrombosis). While maximal aortic diameter remained unchanged (55.6\u2009\u00b1\u20099.1 pre\u2010FLIRT and 54.4\u2009\u00b1\u200913.7 mm at follow\u2010up), true lumen area increased from 7.8\u2009\u00b1\u20092.3 pre\u2010procedure, to 10.6\u2009\u00b1\u20091.5 cm<jats:sup>2<\/jats:sup> at follow\u2010up (<jats:italic>P<\/jats:italic>\u2009=\u20090.016), consistent with remodelling.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Interventional FL management, using the FLIRT concept, is feasible in selected cases of aortic dissection, promotes FL thrombosis and induces successful remodelling.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.27599","type":"journal-article","created":{"date-parts":[[2018,3,30]],"date-time":"2018-03-30T23:50:34Z","timestamp":1522453834000},"page":"732-740","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["False lumen intervention to promote remodelling and thrombosis\u2014The <scp>FLIRT<\/scp> concept in aortic dissection"],"prefix":"10.1002","volume":"92","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6843-6466","authenticated-orcid":false,"given":"Xun","family":"Yuan","sequence":"first","affiliation":[{"name":"Cardiology and Aortic Centre Royal Brompton &amp; Harefield NHS Foundation Trust; Imperial College London London SW3 6NP United Kingdom"},{"name":"Department of Internal Medicine, Coronary Heart Disease Centre, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Centre for Cardiovascular Disease Chinese Academy of Medical Science and Peking Union Medical College Beijing 100037 China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas","family":"Mitsis","sequence":"additional","affiliation":[{"name":"Cardiology and Aortic Centre Royal Brompton &amp; Harefield NHS Foundation Trust; Imperial College London London SW3 6NP United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Semple","sequence":"additional","affiliation":[{"name":"Radiology Department Royal Brompton &amp; Harefield NHS Foundation Trust London SW3 6NP United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mireya","family":"Castro Verdes","sequence":"additional","affiliation":[{"name":"Cardiology and Aortic Centre Royal Brompton &amp; Harefield NHS Foundation Trust; Imperial College London London SW3 6NP United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Esther","family":"Cambronero\u2010Cortinas","sequence":"additional","affiliation":[{"name":"Cardiology and Aortic Centre Royal Brompton &amp; Harefield NHS Foundation Trust; Imperial College London London SW3 6NP United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yida","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Coronary Heart Disease Centre, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Centre for Cardiovascular Disease Chinese Academy of Medical Science and Peking Union Medical College Beijing 100037 China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christoph A.","family":"Nienaber","sequence":"additional","affiliation":[{"name":"Cardiology and Aortic Centre Royal Brompton &amp; Harefield NHS Foundation Trust; Imperial College London London SW3 6NP United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,3,30]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.106.630400"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11748-017-0817-6"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2009.11.014"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehu281"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2016.06.005"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrdp.2016.71"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2009.09.029"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa063232"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2016.05.036"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.avsg.2016.06.017"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1583\/13-4318.1"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.avsg.2016.08.034"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1583\/13-4463MR-R.1"},{"key":"e_1_2_9_15_1","doi-asserted-by":"crossref","first-page":"I260","DOI":"10.1161\/CIRCULATIONAHA.104.525972","article-title":"How to guide stent\u2010graft implantation in type B aortic dissection? Comparison of angiography, transesophageal echocardiography, and intravascular ultrasound","volume":"112","author":"Koschyk DH","year":"2005","journal-title":"Circulation"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1583\/08-2497.1"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezw240"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1010-7940(97)00091-2"},{"key":"e_1_2_9_19_1","first-page":"II22","article-title":"Acute and chronic aortic dissections\u2013determinants of long\u2010term outcome for operative survivors","volume":"72","author":"Haverich A","year":"1985","journal-title":"Circulation"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1067\/mtc.2002.123131"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.111.090266"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2016.07.111"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9149(01)01556-9"},{"key":"e_1_2_9_24_1","first-page":"307","article-title":"Endovascular management of chronic post\u2010dissection aneurysms","volume":"3","author":"Oikonomou K","year":"2014","journal-title":"Ann Cardiothorac Surg"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2011.08.018"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2017.06.005"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.avsg.2016.06.030"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvir.2016.07.007"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1583\/JEVT-12-3844R.1"},{"key":"e_1_2_9_30_1","first-page":"152660281772506","article-title":"Novel endovascular management of proximal type A (DeBakey II) aortic dissection with a patent foramen ovale occluder","volume":"1","author":"Yuan X","year":"2017","journal-title":"J Endovasc Ther"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1258\/vasc.2010.oa0257"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diii.2017.01.003"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2016.06.101"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2016.07.078"},{"key":"e_1_2_9_35_1","first-page":"270","article-title":"Evidence for and risks of endovascular treatment of asymptomatic acute type B aortic dissection","volume":"58","author":"Clough RE","year":"2017","journal-title":"J Cardiovasc Surg (Torino)"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCIMAGING.116.005709"}],"container-title":["Catheterization and Cardiovascular Interventions"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fccd.27599","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccd.27599","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,15]],"date-time":"2023-09-15T12:48:53Z","timestamp":1694782133000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccd.27599"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,3,30]]},"references-count":35,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2018,10]]}},"alternative-id":["10.1002\/ccd.27599"],"URL":"https:\/\/doi.org\/10.1002\/ccd.27599","archive":["Portico"],"relation":{},"ISSN":["1522-1946","1522-726X"],"issn-type":[{"type":"print","value":"1522-1946"},{"type":"electronic","value":"1522-726X"}],"subject":[],"published":{"date-parts":[[2018,3,30]]},"assertion":[{"value":"2017-12-10","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-02-23","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-03-30","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}