Aortic dissection is a rare, severe condition with a hospital mortality rate up to 30% and unpredictable long-term lumen remodeling. Despite advancements in endovascular therapy, aortic dissection treatment remains unclear and debated. The STABILISE technique, introduced in 2014 for type B aortic dissection, combines endovascular stent-grafting with a bare-metal stent to enhance aortic remodeling and true lumen reconstitution, potentially improving long-term outcomes and reducing reinterventions. However, comprehensive data on its long-term efficacy are still limited.

We performed a monocentric, retrospective observational study at a tertiary care center from 2019 to 2024 for all patients who underwent the STABILISE technique for aortic dissection. We reviewed patient demographics, procedural details, clinical and radiological outcomes. Primary endpoints included mortality and technical success at 30 days. Secondary endpoints were mortality, technical success, false lumen thrombosis, complications, and the need for reintervention at 6 months and 1 year.

The study included 25 patients, 80% male, with a mean age of 58±12 years. Five patients (20%) had prior open surgery for ascending aortic dissection. Most patients were treated in the acute (60%) or subacute phase (32%). The proximal landing zone was mainly zone 2 (52%) and zone 3 (40%). The in-hospital mortality rate was 4% (1/25). At 30 days, renal insufficiency was the most common complication, affecting 36% (9/25) of patients, followed by pulmonary and cerebrovascular issues. No case of spinal cord ischemia was reported. At 6 months, there were no additional deaths or new complications, but 8% (2/25) were lost to follow-up. Regarding aortic remodeling at 6 months, false lumen thrombosis occurred in 10 patients (40%), 9 (36%) had partial thrombosis, and 4 patients (16%) required reintervention: 3 had TEVAR and 1 had BEVAR. At 1 year, false lumen thrombosis and partial thrombosis increased to 50% and 43.7%, respectively. No further reoperations were needed at 1 year.

The STABILISE technique demonstrates high procedural success and positive outcomes in aortic remodeling and patient survival, with manageable complications. These results endorse its use as an effective treatment for aortic dissections, though further evaluation and extended follow-up are essential to fully establish its role in clinical practice.