Endovascular repair of Stanford B aortic dissection using two stent grafts with different sizes Xiaoyong Huang, MD, Lianjun Huang, MD, Lizhong Sun, MD,

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Endovascular repair of Stanford B aortic dissection using two stent grafts with different sizes Xiaoyong Huang, MD, Lianjun Huang, MD, Lizhong Sun, MD, Shangdong Xu, MD, Yuguo Xue, MD, Qinglong Zeng, MD, Xi Guo, MD, Mingliang Peng, MD Journal of Vascular Surgery Volume 62, Issue 1, Pages 43-48 (July 2015) DOI: 10.1016/j.jvs.2015.02.022 Copyright © 2015 Society for Vascular Surgery Terms and Conditions

Fig 1 Working schematic diagram shows two-stent graft implantation (TSI) in Stanford type B aortic dissection therapy. a, Stanford type B aortic dissection, multiple intimal tears, and distal landing zone (DLZ) situation. b, The first stent graft seals the primary entrance in the traditional way of implantation, but the distal tear in the thoracic aorta cannot be covered. c, TSI using the second tapered stent graft aims at DLZ implantation accurately, sealing intimal tears of the whole thoracic aorta. At the same time, excessive expansion of the distal stent end can be avoided. FL, False lumen; TL, true lumen. Journal of Vascular Surgery 2015 62, 43-48DOI: (10.1016/j.jvs.2015.02.022) Copyright © 2015 Society for Vascular Surgery Terms and Conditions

Fig 2 A 68-year-old man who presented with chest and back pain for 2 months was diagnosed with Stanford B aortic dissection. a, Intraoperative digital subtraction angiography demonstrated “mirror S” aorta appearance and compressed true lumen. b, Postoperative digital subtraction angiography showed satisfactory repair for dissected aorta by two-stent graft implantation (TSI) with distal landing zone (DLZ) distal to the bending portion of the aorta. Total stent length was 223 mm, and the diameter taper was 8 mm. The left subclavian artery and celiac artery were preserved. Journal of Vascular Surgery 2015 62, 43-48DOI: (10.1016/j.jvs.2015.02.022) Copyright © 2015 Society for Vascular Surgery Terms and Conditions