A narrative review on endovascular false lumen management options in chronic aortic dissection

Nana, Petroula; Eleshra, Ahmed; Torrealba, José I.; Panuccio, Giuseppe; Rohlffs, Fiona; Yousef-al-Sarhan, Daour; Kölbel, Tilo

doi:10.1016/j.jvsvi.2024.100096

JVS-Vascular Insights

2024

DOI: 10.1016/j.jvsvi.2024.100096

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A narrative review on endovascular false lumen management options in chronic aortic dissection

Petroula Nana,

Ahmed Eleshra,

José I. Torrealba

et al.

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2024

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Physician-modified funnel-shaped covered stent for selective false lumen exclusion in chronic type B aortic dissection

Torri,

Nana,

Panuccio

et al. 2024

Vascular

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Purpose To describe the technique of off-centering a balloon-expandable covered stent for selective occlusion of a distal entry tear (ET) in a patient, conservatively treated for chronic type B aortic dissection (cTBAD), presenting FL expansion. Technique A 63-year-old male, with conservatively managed cTBAD, presented at follow-up with FL partial thrombosis and expansion (thoracic aorta FL from 21 mm to 27 mm and abdominal aorta FL from 11 mm to 15 mm in 6 months). No proximal ET was identifiable. Distal FL perfusion was caused by an ET in the abdominal aorta feeding a 2 mm accessory renal artery (ARA). As the aortic diameter was below the threshold for endovascular repair, a selective occlusion of the distal ET and ARA was planned. A balloon-expandable covered stent was modified by off-centering the covered stent proximally and resulting in a funnel-shape occluder after deployment across the ET into the ARA. To prevent type Ic endoleak due to possible FL expansion caused by an intra-operatively detected phrenic artery (PA), coils were deployed into the lumen of the modified stent and the ARA. The pre-discharge computed tomography angiography showed exclusion of both the ARA and ET and a type 2 endoleak from the PA. Conclusion A balloon-expandable covered stent can be modified by off-centering the covered stent resulting in a funnel shape to adapt to different diameter requirements.

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Physician-modified funnel-shaped covered stent for selective false lumen exclusion in chronic type B aortic dissection

Torri,

Nana,

Panuccio

et al. 2024

Vascular

View full text Add to dashboard Cite

show abstract

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A narrative review on endovascular false lumen management options in chronic aortic dissection

Cited by 1 publication

References 40 publications

Physician-modified funnel-shaped covered stent for selective false lumen exclusion in chronic type B aortic dissection

Physician-modified funnel-shaped covered stent for selective false lumen exclusion in chronic type B aortic dissection

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