A modified candy-plug technique to occlude false lumen in aortic dissection.

Area of Science:

• Cardiovascular Surgery
• Endovascular Techniques
• Aortic Disease Management

Background:

• Type A aortic dissection can lead to persistent false lumen (FL) filling and aortic dilation.
• Endovascular Aortic Repair (TEVAR) may not always resolve retrograde FL flow from distal tears.
• Management of residual FL backflow after initial aortic repair presents a clinical challenge.

Purpose of the Study:

• To introduce a modified, custom-created candy-plug (CP) device for endovascular occlusion of false lumen (FL).
• To demonstrate the utility of this novel CP device in a patient with persistent FL backflow after TEVAR.
• To present a technique for managing retrograde FL filling in complex aortic dissection.

Main Methods:

• Modification of a commercially available aortic extender endoprosthesis into a candy-plug (CP) device.
• Endovascular positioning of the custom CP device into the false lumen (FL) of the distal descending thoracic aorta.
• Procedure performed under local anesthesia in a patient with a history of type A aortic dissection and TEVAR.

Main Results:

• Successful occlusion of retrograde false lumen (FL) filling was achieved.
• Aortic diameter decreased from 69 mm to 66 mm at 1-month follow-up.
• False lumen (FL) diameter reduced from 37 mm to 34 mm, while true lumen (TL) remained stable at 32 mm.

Conclusions:

• The modified candy-plug (CP) technique is an effective method for occluding retrograde false lumen (FL) filling in aortic dissection.
• This approach offers a viable solution for managing persistent FL backflow after initial aortic interventions.
• The described technique provides a novel option for improving outcomes in complex aortic dissection cases.