Use of the Octopus Endograft Technique to Reconstruct Renovisceral Arteries Arising From the False Lumen of a Rapidly Expanding Type B Aortic Dissection After Endovascular Repair

作者：Xiong, Jiang; Ge, Yangyang; Liu, Xiaoping; Wang, Lijun; Guo, Wei^*

来源：Journal of Endovascular Therapy, 2017, 24(1): 107-111.

DOI：10.1177/1526602816678993

• endograft
• false lumen
• octopus graft
• parallel grafts
• renovisceral arteries
• stent-graft
• stent-graft-induced new tear
• type B aortic dissection
• thoracoabdominal dissection
• thoracic endovascular aortic repair

Purpose: To describe the use and 6-month outcomes of the octopus endograft technique to reconstruct renovisceral arteries arising from the false lumen (FL) of a type B aortic dissection after thoracic endovascular aortic repair (TEVAR). Case Report: A 46-year-old man post TEVAR for type B aortic dissection was admitted with persistent back pain and a rapidly expanding residual dissection. The celiac and left renal arteries arose from the FL and the superior mesenteric artery from both lumens, with the FL as its main supply. A 20% oversized Endurant stent-graft was deployed with the short limb just above the beginning of the dissection flap and the long limb in the aortic true lumen. A 120-mm-long Endurant extended limb was delivered antegradely via a conduit and deployed into the FL, with a 3-cm overlap with the short limb of the Endurant main body. The 3 renovisceral arteries were reconstructed by lining each with a series of Viabahn or Fluency stent-grafts whose proximal ends were subsequently placed parallel in the FL Endurant extended limb and dilated with kissing balloons. Imaging at 6 months showed an excluded FL, without stenosis or occlusion in the stent-graft or the renovisceral arteries. Conclusion: This case illustrates the successful use of the octopus endograft technique to reconstruct renovisceral arteries arising from a rapidly expanding FL in a post-TEVAR type B aortic dissection; the technique might be applicable in carefully selected patients.

• 出版日期2017-2
• 单位中国人民解放军总医院