False lumen patency is a poor prognostic factor for favorable aortic remodeling in patients with chronic aortic dissection. Several endovascular techniques are available to obliterate the false lumen; however, they are not always successful. We present the case of a 55-year old male with a chronic type B dissection and a large descending thoracic aortic aneurysm with rapid growth, up to 90 mm, despite attempted control of the false lumen with several endovascular devices (thoracic aortic stent graft, Amplatzer device, glue and candy plug). Successful aneurysmal open repair was achieved by removing these devices during the procedure. This case demonstrates the technical challenges of explanting an aortic stent graft and multiple other devices during distal aortic repair.
Keywords: Endovascular therapy; TEVAR; Thoracoabdominal aorta; Thoracoabdominal aortic aneurysm; Thoracoabdominal aortic replacement.
© The Author 2022. Published by MMCTS on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.