Purpose: To evaluate the feasibility and efficacy of a vascular occluder to treat a patent re-entry tear near a visceral artery after stent-graft repair of Stanford type B aortic dissection.
Case report: A 34-year-old woman with a history of stent-graft repair for aortic dissection 6 months ago was admitted complaining of recurrent chest discomfort for 1 month. Computed tomographic angiography (CTA) revealed a proximal type I endoleak and a patent re-entry tear above the celiac artery orifice. A double-disk vascular occluder was used to treat the re-entry tear. The device was deployed successfully without perioperative complications; the re-entry tear was closed and perfusion of adjacent vessels was not compromised. CTA at 3 months and 1 year documented thrombus formation in the false lumen, proper position of the occluder, and no re-entry tear.
Conclusion: It is feasible to treat patent re-entry tears with a vascular occluder after primary proximal stent-graft repairs. Long-term clinical efficacy has yet to be confirmed.