title: The PETTICOAT Technique for Complicated Acute Stanford Type B Aortic Dissection Using a Tapered Self-Expanding Nitinol Device as Distal Uncovered Stent.
abstract: BACKGROUND
  Provisional Extension To Induce Complete Attachment (PETTICOAT) technique has shown good results in the treatment of acute type B aortic dissections (ABAD). Usually, uncovered tubular stainless steel stents are used to promote distal true lumen reattachment.
  
  
  METHODS
  We describe the Petticoat technique using a conic self-expanding nitinol device as distal uncovered stent in five cases of complicated ABAD. We used as distal uncovered stent the single-flared E-XL (Jotec-GmbH).
  
  
  RESULTS
  In one case, renal arteries were successfully stented through the large cells of the E-XL. No perioperative complications were reported. During follow-up (18-24 months), positive remodeling of the entire aorta occurred in 3 cases; in 1 case with associated thoracoabdominal aneurysm, false lumen thrombosis at the thoracic level with true lumen expansion at the visceral aorta was detected at the 18-month CT angiogram, and in 1 patient with Marfan syndrome, open surgical conversion with the E-XL explantation was performed after 24 months due to aneurysmal evolution at the visceral level.
  
  
  CONCLUSIONS
  The E-XL can be successfully used in ABAD. It adapts to different aortic diameters, and its major radial force promotes successful positive remodeling. The open cell structure allows visceral arteries stenting, and it can be removed without complications during open conversion.
authors.affiliation: Department of Cardiac, Thoracic and Vascular Sciences, Vascular and Endovascular Surgery Clinic, Padova University, School of Medicine, Padova, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Antonello
authors.affiliation: Department of Cardiac, Thoracic and Vascular Sciences, Vascular and Endovascular Surgery Clinic, Padova University, School of Medicine, Padova, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Squizzato
authors.affiliation: Department of Cardiac, Thoracic and Vascular Sciences, Vascular and Endovascular Surgery Clinic, Padova University, School of Medicine, Padova, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Colacchio
authors.affiliation: Department of Cardiac, Thoracic and Vascular Sciences, Vascular and Endovascular Surgery Clinic, Padova University, School of Medicine, Padova, Italy.
authors.forename: Jacopo
authors.initials: J
authors.lastname: Taglialavoro
authors.affiliation: Department of Cardiac, Thoracic and Vascular Sciences, Vascular and Endovascular Surgery Clinic, Padova University, School of Medicine, Padova, Italy.
authors.forename: Franco
authors.initials: F
authors.lastname: Grego
authors.affiliation: Department of Cardiac, Thoracic and Vascular Sciences, Vascular and Endovascular Surgery Clinic, Padova University, School of Medicine, Padova, Italy. Electronic address: mikpia79@hotmail.com.
authors.forename: Michele
authors.initials: M
authors.lastname: Piazza
mesh_terms: D000328:Adult; D000368:Aged; D000497:Alloys; D000784:Aortic Dissection / Q000000981:diagnostic imaging / Q000601:surgery*; D001014:Aortic Aneurysm / Q000000981:diagnostic imaging / Q000601:surgery*; D001027:Aortography / Q000379:methods; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation* / Q000379:methods; D000072226:Computed Tomography Angiography; D057510:Endovascular Procedures / Q000295:instrumentation* / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D000069322:Self Expandable Metallic Stents; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000497:Alloys; C013616:nitinol