What question did this study set out to answer?

This report aims to highlight the complications of false lumen misdeployment during TEVAR or FET in aortic dissection and the subsequent endovascular treatment options.

March 1, 2026Open Access

Endovascular Salvage After False Lumen Misdeployment of Thoracic Endovascular Aortic Repair or the Frozen Elephant Trunk in Aortic Dissection: A Case Report of Two Patients

Puntos clave

This report aims to highlight the complications of false lumen misdeployment during TEVAR or FET in aortic dissection and the subsequent endovascular treatment options.
Two case reports of patients with aortic dissection and false lumen misdeployment of TEVAR or FET.
Follow-up imaging with computed tomography angiography was performed to assess misdeployment and complications.
Endovascular rescue interventions included fenestration of the intimal flap and additional stent-graft deployment.
Both patients experienced serious complications from stent-graft misdeployment into the false lumen.
Endovascular intervention was successful in rerouting flow into the true lumen, mitigating the severity of the complications.
Timely diagnosis and intervention were critical to the successful management of both cases.

Resumen

Thoracic endovascular aortic repair (TEVAR) and the frozen elephant trunk (FET) are well-established treatment options for aortic dissection (AD). Inadvertent misdeployment of a TEVAR stent graft or FET into the false lumen (FL) can lead to serious complications. We report two cases of FL misdeployment. First, a 68-year-old female with acute Stanford type B AD underwent TEVAR; follow-up computed tomography angiography (CTA) revealed stent-graft misdeployment into the FL. Second, a 44-year-old female with Marfan syndrome, who had undergone supracoronary ascending aortic grafting for type A AD at 25 years of age, underwent urgent FET 19 years later for a symptomatic dissecting arch aneurysm; follow-up CTA confirmed misdeployment into the FL. In both cases, endovascular rescue was performed with fenestration of the intimal flap and additional stent-graft deployment to reroute flow into the true lumen. Misdeployment of TEVAR or FET into the FL is catastrophic but treatable with rapid diagnosis and timely intervention.

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