Stent Graft-Induced New Entry Created at Locations Other Than Both Proximal and Distal Ends

One of the complications after thoracic endovascular aortic repair (TEVAR) is stent graft-induced new entry (SINE). SINE occurs in 5% to 25% of aortic dissection cases treated with TEVAR and is thought to be associated with endograft oversizing and springback force. Although SINE typically occurs at the proximal or distal ends of the endograft, we report a rare case of managing a SINE formation within the main body of the stent graft, distinct from its landing zones. This unusual presentation highlights the importance of recognizing atypical SINE mechanisms and locations, which can lead to significant complications such as endoleak. TAKE-HOME MESSAGES: To prevent SINE after TEVAR, it is crucial to consider not only the landing zone and device sizing but also the entire aortic curvature where the stent graft will be deployed. Careful device selection and procedural planning are required.