Endovascular solution in a complex post-dissectional thoracic aortic aneurysm case

İbrahim Duvan

doi:10.5606/tgkdc.dergisi.2021.21513

İbrahim Duvan¹, Süleyman Sürer¹, Aygül Melike Şenkal¹, İlker İnce¹, Uğursay Kızıltepe¹

¹Department of Cardiovascular Surgery, Health Sciences University, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey

DOI : 10.5606/tgkdc.dergisi.2021.21513

A 45-year-old male patient presented to our clinic with a post-dissectional thoracic aortic aneurysm with the retrograde filling of the false lumen. He previously underwent a Bentall operation and a proximal thoracic endovascular aortic repair. We carried out a bare metal stent implantation concomitant with endograft extension and stent-assisted balloon-induced intimal disruption and relamination procedure consecutively. Although true lumen expansion was achieved, the aneurysmatic dilation of the descending thoracic aorta was kept on expanding due to perfusion of the false lumen by the distal re-entries. Therefore, it was decided to perform a totally false lumen thrombosis by the candy-plug technique. In conclusion, despite being a fatal disease, endovascular treatment of post-dissectional thoracic aortic aneurysm post-dissectional thoracic aortic aneurysm is possible in anatomically suitable patients with a stepwise approach in experienced endovascular centers.

Keywords : Dissecting aneurysm, embolization, endovascular procedures, stent, thoracic aorta

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