Thoracic endovascular aortic repair with true-false-true lumen deployment.

Endovascular treatment of aortic dissection may be complicated by challenges to navigating the true lumen. In this report, we describe treatment of a type B dissection after open type A repair with aneurysmal degeneration, a short-segment occluded true lumen, and a distal re-entry tear near the celiac artery origin. Endovascular septal fenestration and subsequent thoracic endovascular aortic repair were used to bypass the short-segment midthoracic aortic occlusion, successfully excluding the thoracic aortic aneurysm. The patient was discharged without complications, and follow-up imaging demonstrated favorable aortic remodeling. The case demonstrates feasibility of an endovascular bypass of an intervening short-segment occluded true lumen using a thoracic endovascular aortic repair with true-false-true lumen deployment.