Endovascular stent grafting of the downstream aorta after complete arch replacement using the frozen elephant trunk technique for acute type A aortic dissection.

Figure 1: Computed tomography demonstrated an acute type A aortic dissection with the primary entry located on the ascending aorta (black arrow) and a massive effusion in the pericardium (*). The aortic dissection involved the descending aorta, which was dilated to 6.1 cm with an arteriosclerotic aneurysmal change (white arrow), the so-called Cambia classification group III. Figure 2: Thoracic endovascular aortic repair for a coexisting descending aneurysm was performed after complete arch replacement using the frozen elephant trunk technique (A). Computed tomography angiography at 3 months after surgery showed shrinkage of the descending aorta and a decrease in the aneurysm size to 5.6 cm (B).