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Novel and Innovative Hybrid Technique for Type A Aortic Dissection
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A modified candy-plug technique to occlude false lumen in aortic dissection.

Erik Palm1, Antti Valtola2, Hannu Manninen3,4

  • 1Department of Radiology, Kuopio University Hospital, Puijonlaaksontie 2, 70210, Kuopio, Finland. erik.palm@kuh.fi.

CVIR Endovascular
|October 29, 2022
PubMed
Summary
This summary is machine-generated.

A novel candy-plug (CP) device effectively occludes false lumen (FL) backflow in aortic dissection. This modified technique successfully reduced aortic diameter and stopped retrograde FL filling in a patient case.

Keywords:
Aortic dissectionCandy-plugFalse lumen enhancementFalse lumen occlusion

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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.