Endovascular repair with the chimney technique for Stanford type B aortic dissection involving right-sided arch with mirror image branching.

PURPOSE: To report endovascular repair with the chimney technique of type B aortic dissection involving a right-sided aortic arch (RAA).

CASE REPORTS: Two hypertensive men aged 48 and 42 years with symptoms of aortic dissection resistant to medical therapy underwent emergent thoracic endovascular aortic repair with the chimney technique to extend the proximal landing zones. Both patients had right-sided arches with mirror image branching. One patient required a bare metal chimney stent to maintain perfusion to the right subclavian artery, while the other patient had a chimney stent to revascularize the right common carotid artery. Short-term follow-up (1 year and 1 month, respectively) showed that there was positive aortic remodeling, and the chimney stents were patent.

CONCLUSION

Chimney TEVAR seems safe and effective for Stanford type B dissection in patients having RAA with mirror image branching and no sufficient proximal fixation zone.