Black candy-plug technique for a large false lumen in a patient with complicated type B aortic dissection

Persistent false lumen (FL) perfusion after thoracic endovascular aortic repair for type B aortic dissection remains challenging, especially in large FLs. We present successful FL thrombosis using a modified version of the candy-plug-the "black candy-plug" technique. With no re-entry available, the FL was accessed by intravascular ultrasound-guided flap penetration. A modified Excluder aortic extender was deployed in the FL, reinforced with coil-in-plug, and the residual gap was sealed with n-butyl-2-cyanoacrylate, achieving complete FL occlusion. Follow-up computed tomography confirmed stable device position, total FL thrombosis, and favorable early remodeling. The black candy-plug technique offers a practical option for large FLs.