Endovascular management for post-dissection aortic aneurysm after prior proximal repair

Aortic dissection (AD) is a fatal entity, which often involves the thoracic and abdominal aorta extensively. Type A dissections are typically treated with open surgery, while type B dissections are managed conservatively or with endovascular repair. However, post-dissection aortic aneurysms (PDAAs) are common in both types of AD even after the successful sealing of the primary entry tears. PDAAs can cause severe complications including aortic rupture and ischemia of the branch arteries. Various endovascular techniques are used to treat PDAAs after initial repair: endovascular treatment can be performed through the true lumen, the false lumen, the tears, or combinations of said routes. They include the Knickerbocker technique, false lumen embolization, Amplatzer vascular plug, and fenestrated or branched stent grafts. However, no consensus has been reached on the optimal treatment due to a lack of compelling evidence. This review summarizes recent advances in endovascular management of PDAAs after proximal repair.