True-lumen collapse in aortic dissection part II. Evaluation of treatment methods in phantoms with pulsatile flow

Jin Wook Chung, Christopher Elkins, Toyohiko Sakai, Noriyuki Kato, Thomas Vestring, Charles P. Semba, Suzanne M. Slonim, Michael D. Dake

Research output: Contribution to journalArticle

77 Scopus citations

Abstract

PURPOSE: To discover and evaluate the effective treatment methods to prevent or relieve true-lumen collapse in models of aortic dissection. MATERIALS AND METHODS: Two phantoms were built to simulate type B aortic dissection. After true-lumen collapse was induced, experiments were conducted to evaluate the effectiveness of clinically relevant variables in relieving the collapse. Variables included entry-tear size, branch-vessel flow distribution, distal reentry communication between the true and false limbs, aortic fenestrations, and pump output. To test the effect of closing the entry tear, a stent-graft was deployed over the entry tear under physiologic conditions in a mock-flow loop. The difference in the effect of each variable on the prevention and relief of true-lumen collapse was also investigated. RESULTS: It was more difficult to relieve true-lumen collapse than it was to prevent it. Placement of a stent-graft over the entry tear was the most effective method of relieving true-lumen collapse. Less-effective procedures included opening a false-lumen outflow branch and opening the distal reentry branch. Opening the fenestration branch loops, meant to simulate the creation of artificial fenestrations in the intimal flap, did not relieve true-lumen collapse. CONCLUSION: The definitive treatment for true-lumen collapse in aortic dissection is direct repair of the entry tear to decrease false-lumen inflow. Otherwise, increasing the false-lumen outflow and/or creating distal fenestrations between the true and false lumina distal of the level of the compromised aortic branch are less-effective.

Original languageEnglish (US)
Pages (from-to)99-106
Number of pages8
JournalRadiology
Volume214
Issue number1
DOIs
StatePublished - Jan 1 2000
Externally publishedYes

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Keywords

  • Aorta, dissection
  • Aorta, flow dynamics
  • Aorta, grafts and prostheses
  • Aorta, stenosis or obstruction
  • Phantoms

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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