Thoracic Endovascular Aortic Repair Using Vascular Plug for Chronic Type IIIb Aortic Dissection

Area of Science:

• Cardiovascular Surgery
• Vascular Endovascular Therapy
• Aortic Disease Management

Background:

• A 72-year-old male with a history of abdominal aortic aneurysm (AAA) presented with a large 70-mm type IIIb aortic dissection.
• Previous open AAA repair with an 8-mm iliac graft precluded standard endovascular stent graft passage.

Observation:

• The anatomical constraints prevented the use of conventional endovascular repair methods.
• A 5-mm intimal tear was identified as the primary site requiring intervention.

Findings:

• An Amplatzer Vascular Plug was utilized to successfully seal the intimal tear.
• The endovascular plug placement resulted in successful repair of the aortic dissection.

Implications:

• This case demonstrates a viable alternative endovascular strategy for complex aortic dissections when standard grafts are unsuitable.
• The Amplatzer Vascular Plug offers a minimally invasive option for aortic dissection repair, leading to positive patient outcomes and aortic remodeling.