Modified Candy-Plug Technique for Rescue Type B Aortic Dissection with False-Lumen Rupture.

Despite recent advances in surgical techniques and endovascular devices, the management of ruptured type B aortic dissection remains challenging. Herein, we describe a patient with a history of chronic type B aortic dissection who presented to the emergency department with a massive left hemothorax and profound shock. Computed tomography demonstrated a thoracic dissecting aneurysm with false lumen rupture. He underwent emergent thoracic endovascular aortic repair and carotid-carotid crossover bypass in a hybrid operating room. Although the thoracic endovascular aortic repair resulted in suitable sealing over the primary entry tear, aortography revealed prominent retrograde flow through the distal re-entry tear into the false lumen. To depressurize the ruptured aortic segment fully, we implanted a modified candy-plug device in the false lumen and successfully occluded the retrograde flow. This case report illustrates the preliminary experience of using modified candy-plug device to rescue a critical patient with ruptured type B aortic dissection.