Treatment for acute type A aortic dissection with the Ascyrus Medical Dissection Stent in a consecutive series of 57 cases


 
 
 The Ascyrus Medical Dissection Stent (AMDS) has been recently introduced as an alternative for total arch replacement in acute aortic dissection type A (AADA). The aim of this study was to evaluate the postoperative outcomes after AMDS treatment in a large contemporary cohort of AADA patients.
 
 
 
 Data acquisition was performed retrospectively at two German aortic centres between 2020 and 2022 and comprised the perioperative parameters and postoperative results of all AADA patients. All patients treated with the AMDS for AADA were included in the study. The primary endpoint was in-hospital mortality. Secondary endpoints were defined as early postoperative and AMDS-related complications.
 
 
 
 Fifty-seven AADA patients treated by AMDS were included in the study group. The mean age was 64.6±10.8 years and 59.7% (n = 34) were males. The actual in-hospital mortality was considerably lower than the predicted mortality risk by the GERAADA score (16% vs. 22%). The median ICU and in-hospital stay were 5 (IQR: 3-13) and 12 (IQR: 10-22) days, respectively. Postoperative complications comprised renal insufficiency (37%) with need for dialysis (30%), delirium (26%), re-exploration for bleeding (14%), tracheostomy (14%) and new stroke (4%). A new AMDS-related complication (central stent collapse) was observed in 9% (n = 5) by postoperative computed tomography and chest X-ray. The incidence of complete central AMDS collapse did not impact 30-day mortality.
 
 
 
 The AMDS may be successfully used in AADA with acceptable 30-day mortality in accordance with the GERAADA score. However, careful preoperative evaluation of the patient’s individual aortic anatomy regarding potential contraindications and proper device implantation are strongly recommended to avoid complete central AMDS collapse.
