Aortic remodelling hybrid stent insertion during surgical repair of an acute type A aortic dissection

NICE did a rapid review of the published literature on the efficacy and safety of this procedure. This comprised a comprehensive literature search and detailed review of the evidence from 3 sources, which was discussed by the committee. The evidence included 1 single-arm trial, 1 retrospective case series and 1 additional paper, which reported the outcomes of the malperfusion subgroups from the clinical trial. It is presented in the summary of key evidence section in the interventional procedures overview.

The professional experts and the committee considered the key efficacy outcomes to be: reduction in false lumen diameter, improvement in aortic remodelling, resolution of organ malperfusion, survival and quality of life.

The professional experts and the committee considered the key safety outcomes to be: bleeding, extension of further dissection, infection and death.

One patient organisation submission was received and discussed by the committee. Patient commentary was sought but none was received.

The committee was informed that acute type A aortic dissection is a rare condition with a high mortality, and this procedure has a role in managing type A dissections that extend into the aortic arch, supra-aortic vessels and descending aorta.

The committee noted that many approaches are available to manage acute type A aortic dissection and there is no single defined standard of care.