EXTENSIVE VERSUS CONVENTIONAL TREATMENT FOR TYPE A AORTIC DISSECTION: PRELIMINARY RESULTS OF ASCYRUS MEDICAL DISSECTION STENT

Background and Aim: Acute type A aortic dissection (ATAAD) is a critical condition typically managed with high risks extensive surgical interventions, such as open aortic repair, especially for patients with complex anatomies or comorbidities. AMDS offers a less invasive, hybrid approach that stabilizes the true lumen and promotes aortic remodeling, potentially reducing the need for more complex surgery and rate of reintervention. This study compares preliminary outcomes between patients treated with AMDS in Zone 0 and those undergoing conventional surgical treatment such as Ascending aortic replacement ± hemiarch. Methods: Between August 2019 and August 2024 we treated 70 patients for ATAAD. Excluding 54 patients treated with arch replacement and reimplantation of epiaortic vessels, this retrospective analysis compares 8 patients treated with AMDS (AMDS group) and 8 patients treated with ascending aortic replacement ± hemiarch (control group). We collected data on demographics, clinical characteristics, procedural details, and postoperative outcomes. Results: The median age was 57 years for the AMDS group and 66.5 years for the control group. Although there was no significant difference in procedural times and in-hospital mortality between the groups we found a significant difference in aortic remodeling in the AMDS group on follow-up CT scans with complete or partial false lumen thrombosis. Conclusions: AMDS appears to be a promising alternative to conventional surgery for ATAAD, showing improved aortic remodeling despite similar in-hospital mortality rates. However, further studies with larger sample sizes and longer follow-up are needed to confirm the long-term safety and efficacy of AMDS in ATAAD management.