Recurrent Type A Aortic Dissection and New Entry after Endovascular Repair.

Thoracic endovascular aortic repair (TEVAR) for acute type B aortic dissection can be complicated by retrograde type A aortic dissection (RTAD) and stent graft-induced new entry (SINE). A 77-year-old man developed acute type A aortic dissection after TEVAR and subsequently experienced recurrent RTAD and 3 episodes of distal SINE despite multiple surgical and endovascular interventions, eventually dying of postoperative bleeding. This case highlights the potential for repeated RTAD and SINE in the same patient and underscores the importance of careful surgical planning and endovascular device selection in patients with fragile, tortuous dissected aortas.