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An Analysis of Aortic Remodeling in TEVAR for Aortic Dissection: Balloon Flap Fracture vs the Traditional Method
Cenea Kemp, R. Wilson King, Michael Cain, T. Brett Reece, Muhammad Aftab.
University of Colorado, Denver, CO, USA.

OBJECTIVE: The use of balloon flap fracture (BFF) during thoracic endovascular aortic repair (TEVAR) has been shown to facilitate aortic remodeling. However, a comparison between traditional TEVAR and BFF has not been completed. We aimed to analyze post TEVAR aortic remodeling in our patients who underwent TEVAR with BFF compared to without BFF.
METHODS: Our prospectively maintained institutional database was utilized to identify all patients who underwent a TEVAR for aortic dissection between January of 2016 and May of 2022. A total of 63 patients met the inclusion criteria; these patients were divided into a BFF cohort, containing 23 patients, and a TEVAR without BFF cohort, containing 40 patients.
RESULTS: The preoperative CT as well as postoperative scans completed at 3 months, 6 months, 1 year, and >1 year following the initial TEVAR were reviewed. Measurements were taken for the true, false, and total aortic lumen 2cm distal to the left subclavian, at the mid descending, at the distal landing zone or proximal to the celiac axis, between the celiac and superior mesenteric arteries, at the infrarenal aorta, and just proximal to the aortic bifurcation. An increase in the ratio of the true to total lumen was seen in both the TEVAR with and without BFF cohorts. However, the increase in the true lumen diameter was more prominent in the BFF cohort within the thoracic aorta.
CONCLUSIONS: BFF during TEVAR for aortic dissection facilitates increased aortic remodeling resulting in a smaller false lumen and larger true lumen diameter over time.


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