Spot stenting of the tear in type B aortic dissection

Abstract

Background: In selected type B acute aortic dissection with aortic growth and patent false lumen, an intervention may be required to prevent aortic rupture. Apart from stent grafting of the thoracic aorta, aimed at occluding the primary intimal tear, some have advocated closure of reentry tears by stent grafting of the aortic true lumen after hybrid revascularization of the excluded viscera or by branched aortic endografts.

Methods: We describe a simple technique for occluding a major reentry tear in the visceral abdominal aorta, using on-the-shelf covered stent grafts, arising from the aortic true lumen, crossing the dissection septum tear and aortic false lumen, and being distally anchored in the visceral branch vessel, acting as a rivet on the dissection septum tear, achieving aortic false lumen thrombosis.

Results: In selected cases, we achieved aortic false lumen thrombosis by spot stenting of the tear.

Conclusions: This spot stenting technique may be a useful way of achieving complete false lumen thrombosis or lowering the false lumen pressure of degenerating dissecting aneurysms.