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Related Experiment Video

Updated: Jul 31, 2025

Novel and Innovative Hybrid Technique for Type A Aortic Dissection

Novel and Innovative Hybrid Technique for Type A Aortic Dissection

Published on: March 28, 2025

Initial experience with a modified "candy-plug" technique for false lumen embolization in chronic type B aortic

Daniel Miles¹, Cassra Arbabi¹, Katherine McMackin²

¹Division of Vascular Surgery, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA.

Journal of Vascular Surgery Cases and Innovative Techniques

|May 8, 2023

Summary

A modified candy-plug technique effectively embolizes the false lumen in type B aortic dissection patients after TEVAR, preventing aneurysm expansion. This minimally invasive approach shows promising results for managing persistent perfusion and promoting aortic remodeling.

Keywords:

Aortic remodeling Candy-plug False lumen embolization False lumen perfusion TEVAR Type B aortic dissection

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Published on: October 20, 2023

Area of Science:

Cardiovascular Surgery
Endovascular Interventions
Aortic Disease Management

Background:

Persistent distal false lumen (FL) perfusion after thoracic endovascular aortic repair (TEVAR) for type B aortic dissection (TBAD) is a significant risk factor for aneurysmal degeneration and rupture.
Current management strategies for persistent FL perfusion require further refinement to improve outcomes and prevent complications.

Purpose of the Study:

To evaluate the initial experience and efficacy of a modified "candy-plug" (CP) technique for embolizing persistent distal FL perfusion in patients with chronic TBAD following TEVAR.
To assess the technical and clinical success rates of the modified CP technique in preventing aneurysm expansion.

Main Methods:

Six patients with chronic TBAD and persistent FL perfusion underwent TEVAR with a modified CP technique using a constrained stent graft and an occluding plug.
The technique involved bilateral femoral artery access, intravascular ultrasound guidance, and deployment of the modified device in the FL.
Completion angiography confirmed successful FL embolization, and follow-up imaging assessed aneurysm stability.

Main Results:

The modified CP technique achieved 100% technical success in all six patients.
No 30-day mortality or major adverse events (myocardial infarction, stroke, spinal cord ischemia) were observed.
Clinical success, defined as cessation of aneurysm growth, was confirmed in all available follow-up cases at a mean of 10 months.

Conclusions:

The modified CP embolization technique is a safe and effective adjunct to TEVAR for managing persistent distal FL perfusion in TBAD.
This technique shows potential for promoting aortic remodeling and warrants further investigation for long-term durability.