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Buia et al. Vessel Plus 2022;6:48 Vessel Plus
DOI: 10.20517/2574-1209.2022.04

Technical Note Open Access

New endovascular techniques for false lumen

thrombosis in aortic dissection after thoracic
endovascular aortic repair

Francesco Buia, Vincenzo Russo, Domenico Attinà, Fabio Niro, Luigi Lovato

Pediatric and adult cardiovascular, thoraco-abdominal and emergencies Radiology Unit, Department of Radiology, IRCCS,
Azienda ospedaliera-universitaria di Bologna, Bologna 40138, Italy.
Correspondence to: Dr. Francesco Buia, Pediatric and adult cardiovascular, thoraco-abdominal and emergencies Radiology Unit,
Department of Radiology, IRCCS Azienda ospedaliera-universitaria di Bologna, Via Massarenti 9, Bologna 40138, Italy. E-mail:
francesco.buia@aosp.bo.it

How to cite this article: Buia F, Russo V, Attinà D, Niro F, Lovato L. New endovascular techniques for false lumen thrombosis in
aortic dissection after thoracic endovascular aortic repair. Vessel Plus 2022;6:48. https://dx.doi.org/10.20517/2574-
1209.2022.04
Received: 18 Jan 2022 First Decision: 25 Mar 2022 Revised: 19 May 2022 Accepted: 22 Jul 2022 Published: 1 Sep 2022

Academic Editor: Alisa Wang Copy Editor: Haixia Wang Production Editor: Haixia Wang

Abstract
Over the past decades, both open surgery and endovascular treatment of aortic dissection have made great
progress with good clinical outcomes. However, despite this progress, the presence of distal re-entry tears can
sustain perfusion of false lumen (FL) and induce aneurysm formation or growth. In particular, about 20% of
patients undergoing thoracic endovascular aortic repair (TEVAR) for aortic dissection require reintervention
because of incomplete FL thrombosis promoting aortic wall degeneration, post-dissection aortic aneurysm, and
rupture. Endovascular techniques to promote FL thrombosis after TEVAR show good early results together with
minimal invasiveness, offering different alternatives depending on the case and the level of urgency. Endovascular
techniques include FL embolization (with coils, vascular plugs, etc.), candy-plug techniques, parallel stent graft, and
branched and fenestrated aortic endoprosthesis. Each of these solutions has advantages and disadvantages. We
herein describe the available endovascular options.

Keywords: Aortic dissection, false lumen thrombosis, endovascular repair, thoracic endovascular aortic repair,
TEVAR

© The Author(s) 2022. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, sharing,
adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as
long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and
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