Impact of endovascular false lumen embolization on thoracic aortic remodeling in chronic dissection.

Background Retrograde false lumen (FL) perfusion after thoracic endovascular aortic repair (TEVAR) for chronic dissection is a mode of treatment failure. Thrombosis of the FL is associated with favorable reverse remodeling. Objectives are to describe false lumen embolization (FLE) strategy, assess aortic remodeling and survival. Methods From 1/2009 to 12/2017, 51 patients with chronic dissection underwent FLE, most after previous TEVAR. Devices included a combination of: iliac plug (29 patients), coils (19 patients), or nitinol plug (3 patients). Computed tomography (CT) was performed before discharge, at 3 months, and annually (median follow-up 2 years [1 month-7 years]). Results After FLE, mean maximum aortic diameter decreased (64.2±12 to 61.0±13mm [p=0.03]), true lumen diameter increased (24.7±10 to 33.7±8 mm (p Conclusions FLE is an important endovascular adjunct to TEVAR promoting reverse aortic remodeling in select patients with chronic aortic dissection and persistent retrograde FL perfusion.