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.