E-STABILISE Technique: A Solution for Postdissection Thoracic Aortic Aneurysm Repair: The Association of Transcatheter Electosurgical Septotomy with the STABILISE Technique.

BACKGROUND: Postdissection thoracic aortic aneurysm (PD-TAA) treatment represents one of the most challenging scenarios in vascular surgery, and has led to the development of various techniques. This is a retrospective single-center study aiming to show the early results of patients affected by PD-TAA treated by Transcatheter Electrosurgical Septotomy, followed by endovascular remodeling using the STent-Assisted Balloon-Induced intimaL dISruption and rElamination (STABILISE) in aortic dissection repair technique.

METHODS: From January 2023 to December 2024, 10 patients were treated for PD-TAA using this technique. Aneurysmal degeneration involved both the aortic arch and thoracic aorta in 6 cases, while in the remaining 4 cases, only the descending thoracic aorta was involved. After endovascular repair of the aortic arch, when needed, and electrosurgical septotomy of the dissection lamella in the thoraco-abdominal tract, the procedure was completed by thoracic graft and dissection aortic stent placement, followed by aortic ballooning, performed in the same fashion as the STABILISE technique.

RESULTS: Technical success and clinical success were achieved in 100% of cases. No intraoperative and 24-h death and aorta-related complications were recorded. No 30-day mortality was recorded. No aorta-related complication at 30 days was recorded in 9 cases. In one case, a type IB endoleak was recorded and was treated with a branched thoraco-abdominal endograft.

CONCLUSION: These preliminary results suggest that the combination of the Transcatheter Electrosurgical Septotomy (TES) with the STABILISE technique is promising in a selected cohort of patients. Further studies are necessary to confirm these results.