Safety and Performance of Multilayer Stents in Patients With Type B Aortic Dissection: Long-term Results From a Multicenter, Single-Arm Clinical Trial

Treatment of high-risk TBAD patients with multilayer stents is feasible, has an acceptable safety profile, and stabilizes the dissection. Further research is warranted to confirm these findings in other populations of patients.Clinical ImpactNew therapeutic options are needed to meet the ACC/AHA primary goals for thoracic endovascular aortic repair (TEVAR) in patients with type B aortic dissection (TBAD) extending into the abdominal aorta, namely, to prevent aortic rupture, retrograde extension, and antegrade propagation and alleviate malperfusion. The findings of this study indicate that these goals can be met in patients with high-risk TBAD by using multilayer stents, as these devices allow to treat extensively the dissected aorta with adequate survival, a low risk of ischemic complications, and stabilization of the transaortic diameter over long-term follow-up. Interestingly, multilayer stents can meet these clinical goals without sealing the primary tear or inducing complete false lumen thrombosis. The unique design characteristics and mechanism of action offer a new approach to TEVAR treatment for patients with TBAD.