Thoracic Endovascular Aortic Repair into the False Lumen in Chronic Aortic Dissection.

BACKGROUND: Deployment of a stent graft for the treatment of aortic dissections is normally performed in the true lumen. However, in some rare occasions landing in the false lumen may be appropriate.

METHODS: We present 2 different cases of chronic aortic dissection, where we opted to land the stent graft into the false lumen to treat the associated aneurysm.

RESULTS: For the first case, the goal of thoracic endovascular aortic repair (TEVAR) was to exclude the aneurysm from within the false lumen because of a slit-like true lumen. In the second case, the visceral arteries came off the false lumen, with the renal vessels from the true lumen. False lumen TEVAR was performed, and the infrarenal aorta fenestrated, as to ensure adequate perfusion.

CONCLUSIONS: These different clinical scenarios show how false lumen TEVAR for chronic dissections with associated aneurysms can be an alternative treatment approach and highlight the importance of assessing the origin of branch vessels and the possible necessity of reperfusion of these, before TEVAR is performed.