Pulsatile thrombus evacuation from the false lumen of an occluded carotid artery in acute aortic dissection.

Herein, we present a case of aortic dissection with right carotid artery occlusion that was treated successfully with thrombus evacuation from the false lumen of the occluded carotid artery during hemiarch replacement. This procedure is performed with two maneuvers: aggressive retrieval of the thrombus from the innominate artery during circulatory arrest and thrombus evacuation from the false lumen of the right common carotid artery through a right neck incision with the heart beating. In this alternative method, thrombi can be evacuated more naturally and briskly, using pulsatile flow.