title: Candy-Plug Technique Using an Excluder Aortic Extender for Distal Occlusion of a Large False Lumen Aneurysm in Chronic Aortic Dissection.
abstract: OBJECTIVE
  To describe the candy-plug technique using an Excluder aortic extender for distal occlusion of a large false lumen aneurysm in chronic aortic dissection.
  
  
  METHODS
  A 60-year-old female patient with a history of chronic type B aortic dissection and high-dose steroid use for Churg-Strauss syndrome developed a large 6.2 cm maximum diameter false lumen aneurysm. She underwent thoracic endovascular aortic repair from the left common carotid artery to the descending aorta to cover the proximal entry at the level of distal arch, with coil embolization of the left subclavian artery. To occlude the large false lumen from the reentry just below the level of the left renal artery ostium, a modified 32×45-mm Excluder aortic extender was deployed in the false lumen through the reentry, and a 16-mm Amplatzer Vascular Plug I was deployed in the waist of the modified Excluder aortic extender for complete occlusion. No obvious technical complication was seen. Contrast-enhanced computed tomography at 1 and 14 months revealed no endoleaks and showed complete false lumen thrombosis.
  
  
  CONCLUSIONS
  The candy-plug technique using the Excluder aortic extender is feasible for occlusion of a large false lumen aneurysm in chronic aortic dissection.
authors.affiliation: Department of Radiology, St. Marianna University, School of Medicine, Kawasaki, Kanagawa, Japan yukky.oct.22@gmail.com.
authors.forename: Yukihisa
authors.initials: Y
authors.lastname: Ogawa
authors.affiliation: Department of Cardiovascular Surgery, St. Marianna University, School of Medicine, Kawasaki, Kanagawa, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Nishimaki
authors.affiliation: Department of Cardiovascular Surgery, St. Marianna University, School of Medicine, Kawasaki, Kanagawa, Japan.
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Chiba
authors.affiliation: Department of Radiology, St. Marianna University, School of Medicine, Kawasaki, Kanagawa, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Murakami
authors.affiliation: Department of Cardiovascular Surgery, St. Marianna University, School of Medicine, Kawasaki, Kanagawa, Japan.
authors.forename: Yuka
authors.initials: Y
authors.lastname: Sakurai
authors.affiliation: Department of Radiology, St. Marianna University, School of Medicine, Kawasaki, Kanagawa, Japan.
authors.forename: Keishi
authors.initials: K
authors.lastname: Fujiwara
authors.affiliation: Department of Cardiovascular Surgery, St. Marianna University, School of Medicine, Kawasaki, Kanagawa, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Miyairi
authors.affiliation: Department of Radiology, St. Marianna University, School of Medicine, Kawasaki, Kanagawa, Japan.
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Nakajima
mesh_terms: D000784:Aortic Dissection / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D017541:Aneurysm, False / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D001027:Aortography / Q000379:methods; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation* / Q000379:methods; D002908:Chronic Disease; D015267:Churg-Strauss Syndrome / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy; D004621:Embolization, Therapeutic; D057510:Endovascular Procedures / Q000295:instrumentation* / Q000379:methods; D005260:Female; D006801:Humans; D008875:Middle Aged; D011474:Prosthesis Design; D015607:Stents; D013256:Steroids / Q000008:administration & dosage; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D013256:Steroids
keywords: Excluder aortic extender; candy-plug technique; chronic aortic dissection; false lumen aneurysm; physician-modified stent-graft; thoracic endovascular aortic repair; vascular plug