Improved remodelling with TEVAR and distal bare metal stent in acute complicated type B dissection

Abstract Background A multicentre Study in Survivors of type B aortic dissection undergoing Stenting (ASSIST) compared both 1-year outcomes and evolution of true and false lumen, e.g. remodelling, in patients with complicated type B aortic dissection subjected to TEVAR with distal true lumen scaffolding by self-expanding Nitinol open stent in comparison to TEVAR alone. Methods ASSIST was a multicentre prospective single arm study comparing clinical and imaging data from 39 consecutive patients (age 59.4 ± 13) who received TEVAR and the JOTEC E-XL® open stent to matched controls treated with TEVAR alone based on 1:1 propensity score matching. Clinical data were collected by an independent CRO and CT images were subjected to blinded core-lab analysis. Results There was no difference in baseline demographics, clinical profiles, morphological data, procedural details and in-hospital and 1-year outcomes between groups. Differences emerged with regards to evolution of both true lumen distal to stent-graft, false lumen over the entire length of dissection, and remodelling (p Conclusions TEVAR for acute complicated type B aortic dissection proved safe and promoted remodelling of the stent-grafted thoracic aorta. Additional scaffolding of true lumen distal to TEVAR with a self-expanding stent supported distal true lumen expansion, false lumen regression and thrombosis with evidence of improved distal remodelling at 1-year.