2.3 ADSORB
The prospective multicentre “Acute Dissection: Stent graft OR Best
medical therapy” (ADSORB) trial randomised 61 patients with acute
un-TBAD into two groups to compare BMT (n=31) with BMT and stent
grafting of the primary entry tear (n=30). Patients were followed up at
set intervals after acute dissection. Primary outcomes included
thrombosis of the FL and aortic enlargement at one year as well as
aortic rupture. No deaths occurred in either group during the first 30
days, still, there were three crossovers from the BMT to the BMT+TAG
group due to progression of disease within 1 week. Brunkwall et al.
reported results after one year of surveillance. FL thrombosis did not
occur in 97% of patients treated with BMT, conversely, FL thrombosis
was observed in 57% of the BMT+TAG group (P<0.001). The
average maximum FL and TL diameters for TAG+BMT were 18.5 mm and 32.2
mm, respectively, versus 25.1 mm and 25.5 mm, respectively, for BMT
(P< 0.001). A maximum FL diameter decrease of 7.0 mm was
recorded in the BMT+TAG group compared to an increase of 4.3 mm in the
BMT group (P<0.001). In addition, no significant difference
was observed in aortic dilation (P=0.5). Finally, it was concluded that
the Gore TAG device can be safely used to treat un-TBAD
[22][27].