title: Distal false lumen occlusion in aortic dissection with a homemade extra-large vascular plug: the candy-plug technique.
abstract: OBJECTIVE
  To report a technique to create an extra-large vascular plug for occlusion of a large distal false lumen in chronic aortic dissection.
  
  
  METHODS
  The "candy-plug" technique is demonstrated in a 58-year-old multimorbid man with a history of complicated acute type B aortic dissection and a 9-cm chronic thoracic false lumen aneurysm. The patient underwent a staged repair with a cervical debranching procedure as a first step and a thoracic endovascular aortic repair from the innominate artery to the celiac artery as a second step. To occlude the large false lumen from a distal route, a stent-graft was modified on-table with a diameter-restricting suture, giving it a wrapped candy-like shape. This plug was deployed into the false lumen, and the remaining opening was occluded with a standard vascular plug. On 3-month follow-up imaging, the thoracic false lumen aneurysm remained completely thrombosed.
  
  
  CONCLUSIONS
  The candy-plug technique can facilitate complete occlusion of chronic thoracic false lumen aneurysm by prohibiting distal false lumen backflow.
authors.affiliation: Department for Vascular Medicine, University Heart Center, University Hospital Hamburg Eppendorf, Hamburg, Germany. tilokoelbel@gmail.com
authors.forename: Tilo
authors.initials: T
authors.lastname: Kölbel
authors.forename: Christina
authors.initials: C
authors.lastname: Lohrenz
authors.forename: Arne
authors.initials: A
authors.lastname: Kieback
authors.forename: Holger
authors.initials: H
authors.lastname: Diener
authors.forename: Eike Sebastian
authors.initials: ES
authors.lastname: Debus
authors.forename: Axel
authors.initials: A
authors.lastname: Larena-Avellaneda
mesh_terms: D000784:Aortic Dissection / Q000150:complications / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000150:complications / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D057510:Endovascular Procedures / Q000295:instrumentation* / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015607:Stents