Intercostal artery embolization to induce false lumen thrombosis in type B aortic dissection

Gregory A Magee; Jeniann A Yi; David P Kuwayama

doi:10.1016/j.jvscit.2020.05.012

Intercostal artery embolization to induce false lumen thrombosis in type B aortic dissection

J Vasc Surg Cases Innov Tech. 2020 Jun 25;6(3):433-437. doi: 10.1016/j.jvscit.2020.05.012. eCollection 2020 Sep.

Authors

Gregory A Magee¹, Jeniann A Yi², David P Kuwayama³

Affiliations

¹ Division of Vascular Surgery and Endovascular Therapy, Department of Surgery, Keck Medical Center of University of Southern California, Los Angeles, Calif.
² Division of Vascular Surgery and Endovascular Therapy, Department of Surgery, University of Colorado, Aurora, Colo.
³ Section of Vascular Surgery, Department of Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH.

Abstract

Persistent false lumen flow is common after thoracic endovascular aortic repair of type B aortic dissection and may contribute to continued aortic aneurysmal degeneration. We report an innovative technique of intercostal artery embolization within the false lumen for a patient who had incomplete false lumen thrombosis and progressive aortic enlargement after thoracic endovascular aortic repair of chronic type B aortic dissection. Technical success was facilitated by use of on-table cone beam computed tomography angiography, virtual vessel marking, and modern endovascular tools. The patient had no complications from the procedure. Postoperative imaging demonstrated complete thoracic false lumen thrombosis and favorable aortic remodeling with reduction in maximal aortic diameter.

Keywords: Embolization; False lumen; Intercostal artery; Type B aortic dissection.