PMC5028720_01
AngioCT showing Stanford type B aortic dissection.
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F1
AngioCT revealed an acute Stanford type B aortic dissection, extending from the proximal descending thoracic aorta (distal to the origin of the left subclavian artery) to the iliac arteries (Figure 1).
AngioCT showing type Ia endoleak after the TEVAR procedure.
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F2
After the procedure, the patient was asymptomatic. AngioCT after the procedure showed occlusion of the left subclavian artery and an endoleak at the proximal graft attachment site - type Ia endoleak (Figure 2).
AngioCT showing the increase in type Ia endoleak dimension (arrows).
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F3
AngioCT showed an increase in endoleak dimension at the level of the transition between the aortic arch and the proximal descending aorta (Figure 3).
Final position of the prosthesis. White arrows: self-expandable stents at the brachiocephalic trunk and left common carotid artery, placed between aortic wall and aortic endoprosthesis. Black arrow: proximal entry site of the endoleak. Arrow head: proximal landing zone of the aortic endoprosthesis.
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F4
Proximal landing zone of the endoprosthesis was set proximal to the origin of the brachiocephalic trunk (dimension 43 mm x 47 mm), covering the brachiocephalic trunk and left common carotid artery, which would be then perfused by deployment of self-expandable stents, placed between the endoprosthesis and the aortic wall (Figure 4).
AngioCT at 1 month (A), 3 months (B), and 7 months follow-up (C).
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F5
AngioCT at 1, 3, and 7 months follow-up (Figures 5A-C, respectively) confirmed patency of the stents and the persistency of the endoleak, with no increase in its dimension.