BackTable / VI / Podcast / Episode #163

Treating False Lumen Perfusion in Chronic Aortic Dissections

with Dr. Daniel Han

Vascular Surgeon Daniel Han discusses management of persistent false lumen perfusion in chronic aortic dissection, including the Knickerbocker Technique.

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Treating False Lumen Perfusion in Chronic Aortic Dissections with Dr. Daniel Han on the BackTable VI Podcast)
Ep 163 Treating False Lumen Perfusion in Chronic Aortic Dissections with Dr. Daniel Han
00:00 / 01:04

BackTable, LLC (Producer). (2021, November 1). Ep. 163 – Treating False Lumen Perfusion in Chronic Aortic Dissections [Audio podcast]. Retrieved from https://www.backtable.com

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Podcast Contributors

Dr. Daniel Han discusses Treating False Lumen Perfusion in Chronic Aortic Dissections on the BackTable 163 Podcast

Dr. Daniel Han

Dr. Daniel Han is the Associate Program Director of Vascular Surgery Residency and Fellowship at Mount Sinai Health System in New York City.

Dr. Sabeen Dhand discusses Treating False Lumen Perfusion in Chronic Aortic Dissections on the BackTable 163 Podcast

Dr. Sabeen Dhand

Dr. Sabeen Dhand is a practicing interventional radiologist with PIH Health in Los Angeles.

Show Notes

In this episode, vascular surgeon Dr. Daniel Han and our host Dr. Sabeen Dhand discuss various techniques involved in repairing chronic aortic dissections, including Thoracic Endovascular Aortic Repair (TEVAR), Knickerbocker, and candy plug.

Dr. Han starts by reviewing the differences between a true lumen and a false lumen. False lumens are usually formed by a dominant entry tear in the aortic wall with additional fenestrations present. Since the false lumen lacks the three walls of the aorta, it is more easily perfused and compresses the true lumen. He further subdivides aortic dissection into hyperacute, acute, subacute, and chronic dissections, all depending on the chronicity of the tear. With treatment, the goal is to achieve aortic remodeling and fuse the true and false lumens. Dr. Han notes that the more chronic the dissection, the harder it will be to remodel the aorta back to its original state, since it has already started remodeling in the dissected state.

The doctors discuss TEVAR and follow-up results in which Dr. Han would choose to re-intervene. He explains the Knickerbocker technique, in which he uses a balloon to selectively rupture the dissected septum. This establishes contact between the stent graft and the other side of the aorta, effectively creating a physical barrier to retrograde flow in the thoracic aorta. Dr. Han also discusses the candy-plug technique, which results in immediate cessation of blood flow into the thoracic aorta.

Resources

BackTable VI Episode 142: Type B Aortic Dissections with Dr. Frank Arko:
https://www.backtable.com/shows/vi/podcasts/142/type-b-aortic-dissections

Favorable Impact of Thoracic Endovascular Aortic Repair on Survival of Patients with Acute Uncomplicated Type B Aortic Dissection:
https://pubmed.ncbi.nlm.nih.gov/29914833/

Outcomes of Thoracic Endovascular Aortic Repair for Chronic Aortic Dissections:
https://pubmed.ncbi.nlm.nih.gov/29157682/

Disclaimer: The Materials available on BackTable.com are for informational and educational purposes only and are not a substitute for the professional judgment of a healthcare professional in diagnosing and treating patients. The opinions expressed by participants of the BackTable Podcast belong solely to the participants, and do not necessarily reflect the views of BackTable.

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Articles

Topics

Aortic Dissection Condition Overview
Candy-Plug Technique Procedure Prep
False Lumen Perfusion Condition Overview
Knickerbocker Technique Procedure Prep
Thoracic Endovascular Aortic Repair (TEVAR) Procedure Prep
Learn about Vascular Surgery on BackTable VI

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