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].