{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T00:49:08Z","timestamp":1784767748378,"version":"3.55.0"},"reference-count":32,"publisher":"IMR Press","issue":"5","license":[{"start":{"date-parts":[[2023,4,27]],"date-time":"2023-04-27T00:00:00Z","timestamp":1682553600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev. Cardiovasc. Med."],"abstract":"<jats:p>Background: We present an analysis that compares aortic morphological and clinical outcomes of 36 patients, all treated with endovascular uncovered stents implantation preceded or not by stent-graft implantation, or surgical treatment in the context of complex treatment of type A or type B aortic dissection. Methods: Between 2014 and 05\/2018 our team treated 36 patients with acute aortic dissection and end-organ ischemia due to true lumen compression. All clinical and periprocedural data were obtained prospectively, followed by a retrospective analysis. The case series aim is to show induction of aortic remodeling by depressurization of the false lumen and increasing the size of the true lumen by non-covered stents implantation in the aorta and its affected side branches. Secondary endpoints were survival, branch patency, true lumen and false lumen size evolution. Results: Results from the diameter of both lumens measured by computed tomography angiography (CTA) before and at least 1 year after the treatment showed statistically significant differences, patent stents, as well as symptomatic improvement in all patients. Both aorta-related and general mortality in this complex group of patients was 0%. Conclusions: The concept of redirection of flow in aortic dissection with non-covered stents was safe, led to positive aorta remodeling and resulted in excellent survival rate.<\/jats:p>","DOI":"10.31083\/j.rcm2405133","type":"journal-article","created":{"date-parts":[[2023,5,14]],"date-time":"2023-05-14T06:31:37Z","timestamp":1684045897000},"source":"Crossref","is-referenced-by-count":2,"title":["Endovascular Treatment of Complex Aortic Dissection. A Single Center 5 Years' Experience with 36 Patients"],"prefix":"10.31083","volume":"24","author":[{"given":"Ivo","family":"Petrov","sequence":"first","affiliation":[{"name":"Department of Cardiology, angiology and electrophysiology, \u201cAcibadem City Clinic\u201d University Hospital, 1700 Sofia, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zoran","family":"Stankov","sequence":"first","affiliation":[{"name":"Department of Cardiology, angiology and electrophysiology, \u201cAcibadem City Clinic\u201d University Hospital, 1700 Sofia, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Strahil","family":"Vasilev","sequence":"first","affiliation":[{"name":"Department of Cardiology, angiology and electrophysiology, \u201cAcibadem City Clinic\u201d University Hospital, 1700 Sofia, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iveta","family":"Tasheva","sequence":"first","affiliation":[{"name":"Department of Cardiology, angiology and electrophysiology, \u201cAcibadem City Clinic\u201d University Hospital, 1700 Sofia, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Galina","family":"Kozareva","sequence":"first","affiliation":[{"name":"Department of Diagnostic Imaging, \u201cAcibadem City Clinic\u201d University Hospital, 1700 Sofia, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"16242","published-online":{"date-parts":[[2023,4,27]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","unstructured":"Berretta P, Patel HJ, Gleason TG, Sundt TM, Myrmel T, Desai N, et al. IRAD experience on surgical type A acute dissection patients: results and predictors of mortality. Annals of Cardiothoracic Surgery. 2016; 5: 346\u2013351.","DOI":"10.21037\/acs.2016.05.10"},{"key":"ref2","doi-asserted-by":"crossref","unstructured":"Erbel R, Aboyans V, Boileau C, Bossone E, Bartolomeo RD, Eggebrecht H, et al. 2014 ESC Guidelines on the diagnosis and treatment of aortic diseases: Document covering acute and chronic aortic diseases of the thoracic and abdominal aorta of the adult. The Task Force for the Diagnosis and Treatment of Aortic Diseases of the European Society of Cardiology (ESC). European Heart Journal. 2014; 35: 2873\u20132926.","DOI":"10.1093\/eurheartj\/ehu281"},{"key":"ref3","doi-asserted-by":"crossref","unstructured":"Patel HJ, Williams DM, Dasika NL, Suzuki Y, Deeb GM. Operative delay for peripheral malperfusion syndrome in acute type A aortic dissection: a long-term analysis. The Journal of Thoracic and Cardiovascular Surgery. 2008; 135: 1288\u20131296.","DOI":"10.1016\/j.jtcvs.2008.01.026"},{"key":"ref4","doi-asserted-by":"crossref","unstructured":"Berretta P, Trimarchi S, Patel HJ, Gleason TG, Eagle KA, Di Eusanio M. Malperfusion syndromes in type A aortic dissection: what we have learned from IRAD. Journal of Visualized Surgery. 2018; 4: 65.","DOI":"10.21037\/jovs.2018.03.13"},{"key":"ref5","doi-asserted-by":"crossref","unstructured":"Dake MD. Endovascular stent-graft management of thoracic aortic diseases. European Journal of Radiology. 2001; 39: 42\u201349.","DOI":"10.1016\/S0720-048X(01)00341-2"},{"key":"ref6","doi-asserted-by":"crossref","unstructured":"Lombardi JV, Cambria RP, Nienaber CA, Chiesa R, Teebken O, Lee A, et al. Prospective multicenter clinical trial (STABLE) on the endovascular treatment of complicated type B aortic dissection using a composite device design. Journal of Vascular Surgery. 2012; 55: 629\u2013640.e2.","DOI":"10.1016\/j.jvs.2011.10.022"},{"key":"ref7","doi-asserted-by":"crossref","unstructured":"Fattori R, Montgomery D, Lovato L, Kische S, Di Eusanio M, Ince H, et al. Survival after endovascular therapy in patients with type B aortic dissection: a report from the International Registry of Acute Aortic Dissection (IRAD). JACC: Cardiovascular Interventions. 2013; 6: 876\u2013882.","DOI":"10.1016\/j.jcin.2013.05.003"},{"key":"ref8","doi-asserted-by":"crossref","unstructured":"Kazimierczak A, Rynio P, J\u0119drzejczak T, Samad R, Rybicka A, Gutowski P. Aortic Remodeling After Extended PETTICOAT Technique in Acute Aortic Dissection Type III B. Annals of Vascular Surgery. 2020; 66: 183\u2013192.","DOI":"10.1016\/j.avsg.2019.10.056"},{"key":"ref9","doi-asserted-by":"crossref","unstructured":"Nienaber CA, Kische S, Zeller T, Rehders TC, Schneider H, Lorenzen B, et al. 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Seminars in Thoracic and Cardiovascular Surgery. 2017; 29: 173\u2013178.","DOI":"10.1053\/j.semtcvs.2016.10.002"},{"key":"ref24","doi-asserted-by":"crossref","unstructured":"Rupprecht L, Kasprzak P, Schmid C, Kobuch R, Pfister K. The use of an uncovered stent in type A aortic dissection during open aortic surgery. The Journal of Thoracic and Cardiovascular Surgery. 2018; 156: e199\u2013e200.","DOI":"10.1016\/j.jtcvs.2018.06.026"},{"key":"ref25","doi-asserted-by":"crossref","unstructured":"Fattori R, Tsai TT, Myrmel T, Evangelista A, Cooper JV, Trimarchi S, et al. Complicated acute type B dissection: is surgery still the best option?: a report from the International Registry of Acute Aortic Dissection. JACC: Cardiovascular Interventions. 2008; 1: 395\u2013402.","DOI":"10.1016\/j.jcin.2008.04.009"},{"key":"ref26","doi-asserted-by":"crossref","unstructured":"Zeeshan A, Woo EY, Bavaria JE, Fairman RM, Desai ND, Pochettino A, et al. 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