How to exclude the dilated false lumen in patients after a type B aortic dissection? The cork in the bottleneck.

PURPOSE: To report techniques for excluding the dilated false lumen associated with chronic type B aortic dissection following placement of a stent-graft in the true lumen.

CASE REPORTS: Two patients underwent stent-graft implantation for a dilated false lumen after chronic aortic dissection, but the false lumen was not excluded from the circulation by this procedure. The false lumen was obliterated in one case with Greenfield filters and detachable balloons placed above a renal artery orifice that was perfused via the false lumen. This acted like "a cork in the bottleneck" to block retrograde flow into the thoracic portion of the false lumen above the blockade. In the other patient, an occluder device was used as the "cork." In both cases, a good result was obtained. The occluder device is preferred because deployment is more controllable.

CONCLUSIONS

An occluder device may be used like a cork in a bottle to exclude the dilated false lumen in the thoracic aorta after a type B dissection.