The Advantage of Fenestrated Stent Graft for Type B Aortic Dissections

OBJECTIVE Thoracic endovascular aortic repair (TEVAR) for Type B aortic dissections has come into wide use, despite it is still controversial. In addition, many dissections have entries in distal arch. Therefore, in order to cover distal arch entries, stent grafts needs to be placed in aortic arch. However, TEVAR of the aortic arch has anatomical restrictions, such as the proximity to the great vessels and arch tortuosity, and there are no adequate commercially available devices. From 2006, we introduced the TEVAR of the aortic arch with fenestrations strategically placed for each arch branch without the use of extra anatomical bypass. In this year, we performed 2cases fenestrated stent grafting for complicated Type B sub acute dissection. The false lumen was patent and proximal end of devices were placed at Zone 0 in all cases.