Single-institution experience with Shape medical polymer sponge embolization as adjunct therapy for rapid aortic remodeling in the multi-modal management of complex persistent large false lumens following aortic dissection.

Persistent false lumen (FL) pressurization after endovascular repair of aortic dissection is associated with increased aortic morbidity and mortality. Shape memory polymer sponge devices (IMPEDE-FX, Shape Medical) have shown promise in promoting sac regression after endovascular aortic repair in abdominal aortic aneurysms in ongoing trials. Here, we report the adjunct use of these devices as part of a multimodal approach to achieve FL occlusion in three patients (average age, 59 years; male = 2, female = 1) with limited options for the management of their persistent large FL following type A (n = 1) and type B (n = 2) aortic dissections between March and December 2024. FL thrombosis and aortic remodeling were achieved in all three patients based on postoperative imaging within 1 to 6 months after intervention. There was one mortality in a Marfan's patient secondary to Zone 0 aortic rupture 2 months postoperatively, distant from areas of previous intervention. Our early clinical experience with the Shape memory sponge in managing large, complex persistent FL is encouraging, but further prospective studies are needed.