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Feasibility and safety of Stanford A aortic dissection complete endovascular repair system in a porcine model

BACKGROUND: Acute type A aortic dissection (ATAAD) is a catastrophic disease with high morbidity and mortality. Although open surgery is still the gold standard for the treatment of ATAAD, some patients, with advanced age and multiple comorbidities, can only receive medical management alone. Nowaday...

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Autores principales: Peng, Yucheng, Lin, Wenhui, Lou, Deda, Luo, Songyuan, Li, Bo, Su, Mingcheng, Liu, Jitao, Tang, Yue, Luo, Jianfang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10500764/
https://www.ncbi.nlm.nih.gov/pubmed/37704996
http://dx.doi.org/10.1186/s12872-023-03494-3
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author Peng, Yucheng
Lin, Wenhui
Lou, Deda
Luo, Songyuan
Li, Bo
Su, Mingcheng
Liu, Jitao
Tang, Yue
Luo, Jianfang
author_facet Peng, Yucheng
Lin, Wenhui
Lou, Deda
Luo, Songyuan
Li, Bo
Su, Mingcheng
Liu, Jitao
Tang, Yue
Luo, Jianfang
author_sort Peng, Yucheng
collection PubMed
description BACKGROUND: Acute type A aortic dissection (ATAAD) is a catastrophic disease with high morbidity and mortality. Although open surgery is still the gold standard for the treatment of ATAAD, some patients, with advanced age and multiple comorbidities, can only receive medical management alone. Nowadays, thoracic aortic endovascular repair (TEVAR) provides a potential treatment option for the patient with ATAAD, but traditional stent grafts (SGs), which are not designed for the ATAAD, are inapplicable to the unique anatomy of the aortic arch. Therefore, we innovatively created the BRIDGE system (Chuangxin Medical, Shenzhen, China), a complete endovascular reconstruction system designed to treat ATAAD. This study aimed to evaluate the feasibility and safety of the novel Stanford A aortic dissection complete endovascular reconstruction system in a porcine model. METHOD: The BRIDGE system consists of the type A stent system and the type C stent system. Between November 2020 and March 2021, three white swine were utilized in the study. The BRIDGE system was deployed via the transcatheter approach under angiographic guidance. The swine(n = 3) treated with our system were evaluated using angiography before sacrifice 1-month after implantation, which was followed by gross specimen evaluation and histological examination of harvested tissues. RESULT: The acute procedure success rate was 100% (3/3). The immediate post-procedural angiography showed that both type A SGs and type C SGs were deployed in satisfactory locations, with patency of the supra-aortic trunk and no endoleak. The cumulative mortality of 30-day was 0% without any adverse events. No device migration or leakage was observed angiographically, before sacrifice. The gross observation confirmed a type A SG covered part of the entry of anonyma. Favorable endothelialization, no thrombogenesis, and slight inflammatory infiltration of the tissues around the device were confirmed by microscopic examinations in all pigs. CONCLUSION: It was feasible and secure to use Stanford A aortic dissection complete endovascular reconstruction system to implement a transcatheter endovascular repair in a porcine model. With this novel system, treating acute type A aortic dissection may be more efficient and secure in human. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12872-023-03494-3.
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spelling pubmed-105007642023-09-15 Feasibility and safety of Stanford A aortic dissection complete endovascular repair system in a porcine model Peng, Yucheng Lin, Wenhui Lou, Deda Luo, Songyuan Li, Bo Su, Mingcheng Liu, Jitao Tang, Yue Luo, Jianfang BMC Cardiovasc Disord Research BACKGROUND: Acute type A aortic dissection (ATAAD) is a catastrophic disease with high morbidity and mortality. Although open surgery is still the gold standard for the treatment of ATAAD, some patients, with advanced age and multiple comorbidities, can only receive medical management alone. Nowadays, thoracic aortic endovascular repair (TEVAR) provides a potential treatment option for the patient with ATAAD, but traditional stent grafts (SGs), which are not designed for the ATAAD, are inapplicable to the unique anatomy of the aortic arch. Therefore, we innovatively created the BRIDGE system (Chuangxin Medical, Shenzhen, China), a complete endovascular reconstruction system designed to treat ATAAD. This study aimed to evaluate the feasibility and safety of the novel Stanford A aortic dissection complete endovascular reconstruction system in a porcine model. METHOD: The BRIDGE system consists of the type A stent system and the type C stent system. Between November 2020 and March 2021, three white swine were utilized in the study. The BRIDGE system was deployed via the transcatheter approach under angiographic guidance. The swine(n = 3) treated with our system were evaluated using angiography before sacrifice 1-month after implantation, which was followed by gross specimen evaluation and histological examination of harvested tissues. RESULT: The acute procedure success rate was 100% (3/3). The immediate post-procedural angiography showed that both type A SGs and type C SGs were deployed in satisfactory locations, with patency of the supra-aortic trunk and no endoleak. The cumulative mortality of 30-day was 0% without any adverse events. No device migration or leakage was observed angiographically, before sacrifice. The gross observation confirmed a type A SG covered part of the entry of anonyma. Favorable endothelialization, no thrombogenesis, and slight inflammatory infiltration of the tissues around the device were confirmed by microscopic examinations in all pigs. CONCLUSION: It was feasible and secure to use Stanford A aortic dissection complete endovascular reconstruction system to implement a transcatheter endovascular repair in a porcine model. With this novel system, treating acute type A aortic dissection may be more efficient and secure in human. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12872-023-03494-3. BioMed Central 2023-09-13 /pmc/articles/PMC10500764/ /pubmed/37704996 http://dx.doi.org/10.1186/s12872-023-03494-3 Text en © The Author(s) 2023, corrected publication 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Peng, Yucheng
Lin, Wenhui
Lou, Deda
Luo, Songyuan
Li, Bo
Su, Mingcheng
Liu, Jitao
Tang, Yue
Luo, Jianfang
Feasibility and safety of Stanford A aortic dissection complete endovascular repair system in a porcine model
title Feasibility and safety of Stanford A aortic dissection complete endovascular repair system in a porcine model
title_full Feasibility and safety of Stanford A aortic dissection complete endovascular repair system in a porcine model
title_fullStr Feasibility and safety of Stanford A aortic dissection complete endovascular repair system in a porcine model
title_full_unstemmed Feasibility and safety of Stanford A aortic dissection complete endovascular repair system in a porcine model
title_short Feasibility and safety of Stanford A aortic dissection complete endovascular repair system in a porcine model
title_sort feasibility and safety of stanford a aortic dissection complete endovascular repair system in a porcine model
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10500764/
https://www.ncbi.nlm.nih.gov/pubmed/37704996
http://dx.doi.org/10.1186/s12872-023-03494-3
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