A multi-centre study of short and mid-term outcomes of the Ascyrus Medical Dissection Stent (AMDS) in the treatment of acute type A aortic dissection

P0014 

Abstract Submission 

Stuart Grant (1), Mohamed Allam (2), Cha Rajakaruna (3), Eltayeb Mohamed Ahmed (4), David Zicho (5), Mazyar Kanani (2), Andrew Owens (2)

(1) South Tees NHS Foundation Trust, Middlesbrough, NA, (2) South Tees Hospitals NHS Foundation Trust, Middlesbrough, NA, (3) Bristol Heart Institute, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK, Bristol, NA, (4) Bristol Heart Institute, Bristol, NA, (5) Hull University NHS Foundation Trust, Hull, NA

Stuart Grant    -  Contact Me
South Tees NHS Foundation Trust

Mohamed Allam    -  Contact Me
South Tees Hospitals NHS Foundation Trust

Cha Rajakaruna    -  Contact Me
Bristol Heart Institute, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK

Eltayeb Mohamed Ahmed    -  Contact Me
Bristol Heart Institute

David Zicho    -  Contact Me
Hull University NHS Foundation Trust

Mazyar Kanani    -  Contact Me
South Tees Hospitals NHS Foundation Trust

Andrew Owens    -  Contact Me
South Tees Hospitals NHS Foundation Trust

Stuart Grant    -  Contact Me
N/A

Objective
The Ascyrus Medical Dissection Stent (AMDS) is an uncovered aortic arch hybrid graft developed to promote true lumen expansion and enhance aortic remodelling in patients undergoing type A aortic dissection repair. The first implantation in the United Kingdom was performed in early 2021. The objective of this study was to report the short and mid-term outcomes in patients treated with the AMDS.
Methods
This was a multi-centre retrospective analysis of prospectively collected routine clinical data. All patients who presented with an acute type A aortic dissection and received an AMDS stent between January 2021 and September 2023 were included. Anonymised clinical data were transferred to the lead centre for analysis.
Results
A total of 46 patients across four centres were included. The majority (40, 87.0%) were operated as an emergency with six salvage procedures included. Most patients (33, 71.7%) were male and the mean age at operation was 64.4 (SD 12.0). The mean EuroSCORE II was 19.8 (SD 16.4) and 12 (26.1%) of patients presented with malperfusion. The in-hospital mortality rate was 21.7% (10/46) and 15.0% (6/40), overall and for non-salvage patients respectively. The mean duration of follow-up was 10 months with a maximum follow up of 30 months. There were no post-discharge deaths during follow-up with one patient requiring further aortic intervention. False lumen thrombosis was demonstrated on latest follow-up CT scan in 70% (23/33) of patients however there was evidence of descending aortic growth in 27.2% (9/32).
Conclusions
This study demonstrates that the AMDS can be used safely and effectively in patients with acute type A aortic dissection who present with or without malperfusion. No patients died during follow-up after discharge and positive remodelling of the false lumen was seen in the majority of patients. Further studies are required to demonstrate the long-term outcomes of the AMDS device and further define its role in the treatment of acute type A aortic dissection.

Dissection