• Hung-Lung Hsu, Chun-Yang Huang, Hsin-Ying Lu, Chiao-Po Hsu, Po-Lin Chen, I-Ming Chen, and Chun-Che Shih.
• Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei 112 Taiwan; School of Medicine, National Yang Ming Chiao Tung University, Taipei, 112, Taiwan; Division of Cardiovascular Surgery, Cardiovascular Center, Far Eastern Memorial Hospital, New Taipei City, 220, Taiwan; Department of Biotechnology, Ming Chuan University, Taoyuan, 333, Taiwan.
• J Formos Med Assoc. 2022 Sep 1; 121 (9): 174817571748-1757.

Background/PurposeData about volumetric remodeling of the provisional extension to induce complete attachment (PETTICOAT) technique on DeBakey type IIIb aortic dissection in acute and subacute phases were scarce. The proper timing to perform this technique to promote false lumen reduction was also unknown.MethodsPatients with DeBakey type IIIb aortic dissection who underwent the PETTICOAT technique between December 2005 and March 2017 were reviewed and divided into acute (treatment occurred ≦14 days after symptom onset) and subacute (15-90 days) groups. Remodeling parameters of the true and false lumens were analyzed. Receiver operating characteristic curve was used to deduce the timing of this technique.ResultsIn the 2-year follow-up, the acute group (N = 20) demonstrated significant true lumen expansion and false lumen regression in the thoracic, abdominal, and total aorta. However, the subacute group (N = 20) only showed significant shrinkage in the false lumen of the thoracic and total aorta. Using PETTICOAT technique within 36 days after the aortic event may result in better total false lumen reduction.ConclusionFor DeBakey type IIIb aortic dissection, more prominent true lumen expansion and false lumen reduction were noted when using the PETTICOAT technique in the acute phase. When performed within 36 days after symptoms onset, the PETTICOAT technique may potentiate better total false lumen regression.Copyright © 2022. Published by Elsevier B.V.

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