False Lumen Occlusion in Chronic Aortic Dissection: The New Generation Candy-Plug II.


Journal

Annals of vascular surgery
ISSN: 1615-5947
Titre abrégé: Ann Vasc Surg
Pays: Netherlands
ID NLM: 8703941

Informations de publication

Date de publication:
May 2019
Historique:
received: 26 05 2018
accepted: 08 10 2018
pubmed: 29 1 2019
medline: 18 6 2019
entrez: 29 1 2019
Statut: ppublish

Résumé

To introduce the new generation Candy-Plug II with a self-closing channel construction inside the plug. The technique of the Candy-Plug II was demonstrated in a 50-year-old patient with residual chronic aortic dissection and thoracic false lumen aneurysm with false lumen backflow after open surgical repair of the ascending aorta for acute type A aortic dissection. The Candy-Plug Technique was applied in addition to a branched arch procedure using a new generation Candy-Plug II for false lumen occlusion. The Candy-Plug II is a short tubular stent graft with a small open channel inside the graft to accommodate the central cannula and allow retrieval of the dilator tip, which closes itself as soon as the dilator tip is removed. The channel inside the graft is unsupported and will collapse and thereby close. This new design obviates additional placement of a plug to occlude the midsection of the first-generation Candy-Plug. After deployment of the Candy-Plug, distal false lumen occlusion was confirmed on final angiogram and postoperative computed tomography scans without any leakage through the Candy-Plug. The new generation Candy-Plug II is a useful refinement of the previously available model. It reduces the procedural steps and provides a longer sealing segment.

Sections du résumé

BACKGROUND BACKGROUND
To introduce the new generation Candy-Plug II with a self-closing channel construction inside the plug.
METHODS METHODS
The technique of the Candy-Plug II was demonstrated in a 50-year-old patient with residual chronic aortic dissection and thoracic false lumen aneurysm with false lumen backflow after open surgical repair of the ascending aorta for acute type A aortic dissection. The Candy-Plug Technique was applied in addition to a branched arch procedure using a new generation Candy-Plug II for false lumen occlusion. The Candy-Plug II is a short tubular stent graft with a small open channel inside the graft to accommodate the central cannula and allow retrieval of the dilator tip, which closes itself as soon as the dilator tip is removed. The channel inside the graft is unsupported and will collapse and thereby close. This new design obviates additional placement of a plug to occlude the midsection of the first-generation Candy-Plug. After deployment of the Candy-Plug, distal false lumen occlusion was confirmed on final angiogram and postoperative computed tomography scans without any leakage through the Candy-Plug.
CONCLUSIONS CONCLUSIONS
The new generation Candy-Plug II is a useful refinement of the previously available model. It reduces the procedural steps and provides a longer sealing segment.

Identifiants

pubmed: 30690161
pii: S0890-5096(19)30032-9
doi: 10.1016/j.avsg.2018.10.016
pii:
doi:

Types de publication

Case Reports Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

261-265

Informations de copyright

Copyright © 2019 Elsevier Inc. All rights reserved.

Auteurs

Fiona Rohlffs (F)

Department of Vascular Medicine, German Aortic Center, University Heart Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany. Electronic address: f.rohlffs@uke.de.

Nikolaos Tsilimparis (N)

Department of Vascular Medicine, German Aortic Center, University Heart Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany.

John Mogensen (J)

Cook Medical, Bjaeverskov, Denmark.

Vladimir Makaloski (V)

Department of Vascular Medicine, German Aortic Center, University Heart Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany.

Sebastian Debus (S)

Department of Vascular Medicine, German Aortic Center, University Heart Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany.

Tilo Kölbel (T)

Department of Vascular Medicine, German Aortic Center, University Heart Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany.

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