Double-chimney technology for treating secondary type I endoleak after endovascular repair for complicated thoracic aortic dissection Rui Feng, MD, PhD,

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Presentation transcript:

Double-chimney technology for treating secondary type I endoleak after endovascular repair for complicated thoracic aortic dissection Rui Feng, MD, PhD, Zhiqing Zhao, MD, Junmin Bao, MD, PhD, Xiaolong Wei, MD, Liang Wang, MD, Zaiping Jing, MD, PhD Journal of Vascular Surgery Volume 54, Issue 1, Pages 212-215 (July 2011) DOI: 10.1016/j.jvs.2010.11.120 Copyright © 2011 Society for Vascular Surgery Terms and Conditions

Fig 1 A, Aortography showing the Stanford type B dissection with the entry tear (white arrow) and a severe distal arch stenosis and angulation (black arrow). B, Aortography after the first thoracic endovascular aortic repair (TEVAR) showing the excluded entry tear with partial coverage of the left subclavian artery (LSA) origin. Journal of Vascular Surgery 2011 54, 212-215DOI: (10.1016/j.jvs.2010.11.120) Copyright © 2011 Society for Vascular Surgery Terms and Conditions

Fig 2 Computed tomography angiography (CTA) before double-chimney endovascular repair showing the secondary proximal type 1 endoleak and the large false lumen. Journal of Vascular Surgery 2011 54, 212-215DOI: (10.1016/j.jvs.2010.11.120) Copyright © 2011 Society for Vascular Surgery Terms and Conditions

Fig 3 Intraoperative fluoroscopic image at the second thoracic endovascular aortic repair (TEVAR) showing: A, Deployment of the aortic stent graft and the delivered stent extending from the left common carotid artery (CCA) to the aortic arch (arrow). B, Deployment of the second stent in the innominate artery (arrow). C, Completion angiography showing no endoleak into the false lumen, antegrade flow in the innominate and left carotid arteries, exclusion of the left subclavian, and unchanged aortic stricture and angulation. Black arrow: proximal end of the stent in the innominate artery. White arrow: proximal end of the stent in the left CCA. Arrowhead: proximal edge of the fabric of the second Relay stent graft. D, One-year follow-up computed tomography angiography (CTA) showing good device morphology and no leakage, patent innominate and left carotid arteries, and complete thrombosis in the descending aortic false lumen. Journal of Vascular Surgery 2011 54, 212-215DOI: (10.1016/j.jvs.2010.11.120) Copyright © 2011 Society for Vascular Surgery Terms and Conditions