Key result
Custom false lumen occlusion device achieves rapid false lumen thrombosis and exclusion in a DTAA.
Why the study?
Long-term management of chronic type B aortic dissection remains challenging because of continuous false lumen backflow from distal re-entry tears and progressive aortic dilatation despite thoracic endovascular aortic repair.
Does a custom-made false lumen occlusion device (FLOD) combined with endograft extension safely achieve false lumen exclusion in a patient with complex chronic type B aortic dissection?
Case Report (n=1)
No
Does a custom-made false lumen occlusion device (FLOD) combined with endograft extension safely achieve false lumen exclusion in a patient with complex chronic type B aortic dissection?
This first reported case demonstrates that combining endograft extension with a custom false lumen occlusion device (FLOD) is a feasible and effective strategy for achieving rapid false lumen thrombosis in complex chronic type B aortic dissection.
May support feasibility in select chronic type B dissection cases; leaves open need for prospective safety and durability data.
Chronic type B aortic dissection (cTBAD) is a challenging condition frequently complicated by persistent false lumen (FL) perfusion, leading to aneurysmal degeneration. Despite significant advances in thoracic endovascular aortic repair (TEVAR), long-term management remains challenging because of continuous FL backflow from distal re-entry tears and progressive aortic dilatation. We present the first documented case of FL exclusion using a custom-made false lumen occlusion device (FLOD). A 77-year-old male who had undergone TEVAR in 2017 underwent computed tomography angiography (CTA) in 2025, with the results revealing aneurysmal degeneration of the descending thoracic aorta (maximum diameter 58.5 mm) and two distal re-entry tears with substantial FL perfusion. Following multidisciplinary evaluation, the patient underwent endovascular reintervention with proximal stent graft extension and the deployment of a custom FLOD into the FL via femoral access. Completion angiography confirmed proper FL exclusion with preservation of visceral artery patency. Transesophageal echocardiography demonstrated rapid FL thrombosis. The patient was discharged on postoperative day 5 in good condition without complications. This case highlights that combining endograft extension with a dedicated FLOD is a safe and effective strategy for selected patients with complex cTBAD anatomy.
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Casula et al. (2025) conducted a case report in Chronic type B aortic dissection (cTBAD) (n=1). Custom-made false lumen occlusion device (FLOD) was evaluated on False lumen exclusion and thrombosis. Deployment of a custom false lumen occlusion device successfully achieved false lumen exclusion and rapid thrombosis in a 77-year-old male with a 58.5 mm descending thoracic aorta aneurysm.
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