Successful Embolization Therapy through Reentry Tear in the Right Subclavian Artery for Treating Patent False Lumen in the Aortic Arch Formed after Type A Dissection Repair

Figures

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  Fig. 1 Anatomic locations of reentry tears in the RSCA and subsequent FL. Three-dimensional computed tomography scans taken 3 years previously show FL from the reentry tear of the RSCA to aortic arch (A is from front, B is from behind). Aortic angiography performed 3 years previously (C) shows FL flow (arrow line) from the reentry tear of the RSCA to aortic arch. RSCA: right subclavian artery; BCA: brachiocephalic artery; RCCA: right common carotid artery; FL: false lumen

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  Fig. 2 Fluoroscopic images of transcatheter arterial embolization. (A) Angiography shows a reentry tear in the RSCA and FL flow. (B) Image showing “B-glue technique” involving injection of glue under microballoon occlusion. (C) Image showing an indwelling coil at the inlet port of reentry. RSCA: right subclavian artery; FL: false lumen; G: glue; MB: microballoon

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  Fig. 3 Progressive computed tomography scans (axial images of the aortic arch and abdominal aorta below the level of renal artery). (A, B) Image obtained 6 years after AAAD repair but before TAE shows dilatation of the aorta; FL of the aortic arch was possibly thrombosed, and the abdominal aorta of the FL was patent. (C, D) Image obtained 2 years after TAE shows shrinkage and thrombosis of the FL. AAAD: acute type A aortic dissection; TAE: transcatheter arterial embolization; FL: false lumen