What question did this study set out to answer?

This case report aims to present a novel TEVAR technique for managing complicated type B aortic dissections requiring zone 2 landing.

January 10, 2026Journal of Cardiothoracic Surgery0 citationsOpen Access

New approach to type B aortic dissection – zone 2.5 thoracic endovascular aortic repair: a case report

HHHitoki HashiguchiKitami Information Technology (Japan)NYNaomi YasudaSapporo Medical University AOAkihito OhkawaSapporo Medical University

Key Result

The novel TEVAR technique using the left subclavian artery for zone 2 landing resulted in complete entry tear coverage and successful postoperative recovery.

Key Points

This case report aims to present a novel TEVAR technique for managing complicated type B aortic dissections requiring zone 2 landing.
Emergency thoracic endovascular aortic repair (TEVAR) performed on a 42-year-old man.
Used the left subclavian artery wall as a sealing zone to minimize endoleak risk.
Postoperative assessment conducted using CT imaging.
Complete coverage of the entry tear was achieved post-repair.
False lumen thrombosis was noted following the procedure.
Follow-up imaging showed favorable remodeling and preserved perfusion to the left subclavian artery.

Structured PICO

Does Zone 2.5 TEVAR improve procedural success and aortic remodeling in patients with complicated type B aortic dissection requiring zone 2 landing?

Population

A 42-year-old man with complicated type B aortic dissection (TBAD) requiring zone 2 landing, presenting with pulseless left femoral artery and left lower limb ischemia.

Intervention

Zone 2.5 thoracic endovascular aortic repair (TEVAR) using the left subclavian artery (LSA) wall as a sealing zone without LSA revascularization.

Outcome

Complete coverage of the entry tear, false lumen thrombosis, and preserved left subclavian perfusion.surrogate

The novel Zone 2.5 TEVAR technique may be an effective and reproducible option for treating complicated type B aortic dissection in patients with limited proximal sealing zones, avoiding the need for left subclavian artery revascularization.

Main Result

Absolute Event Rate: 0% vs 0%

Abstract

Abstract We report a novel thoracic endovascular aortic repair (TEVAR) technique for complicated type B aortic dissection requiring zone 2 landing. A 42-year-old man presented with pulseless left femoral artery. Emergency TEVAR was performed using the left subclavian artery (LSA) wall as a sealing zone to reduce the risk of endoleak. Postoperative recovery was uneventful, and the patient was discharged on day 8. CT demonstrated complete coverage of the entry tear, false lumen thrombosis, and preserved left subclavian perfusion. Follow-up CT showed favorable remodeling. This technique may be effective in patients with limited proximal sealing zones.

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