Distal sleeve of false lumen occluder displacement through a proximal intimal re-entry potentially causing visceral malperfusion: A word of caution

Nabil Saouti, MD, PhD; Stijn Hazenberg, MD, PhD; Guillaume S.C. Geuzebroek, MD, PhD; Michel W.A. Verkroost, MD; Foeke J. Nauta, MD, PhD; Wilson L. Li, MD; Josst A. van Herwaarden, MD, PhD; Robin H. Heijmen, MD, PhD

doi:10.1016/j.jvscit.2025.101800

Journal of Vascular Surgery Cases and Innovative Techniques (Aug 2025)

Distal sleeve of false lumen occluder displacement through a proximal intimal re-entry potentially causing visceral malperfusion: A word of caution

Nabil Saouti, MD, PhD,
Stijn Hazenberg, MD, PhD,
Guillaume S.C. Geuzebroek, MD, PhD,
Michel W.A. Verkroost, MD,
Foeke J. Nauta, MD, PhD,
Wilson L. Li, MD,
Josst A. van Herwaarden, MD, PhD,
Robin H. Heijmen, MD, PhD

Affiliations

Nabil Saouti, MD, PhD: Department of Cardio-Thoracic Surgery, Radboud UMC, Nijmegen, the Netherlands; Correspondence: Nabil Saouti, MD, PhD, Department of Cardio-Thoracic Surgery, Geert Grotplein Zuid 10, Nijmegen 6500HB, the Netherlands
Stijn Hazenberg, MD, PhD: Department of Vascular Surgery, University Medical Center Utrecht, Utrecht, the Netherlands
Guillaume S.C. Geuzebroek, MD, PhD: Department of Cardio-Thoracic Surgery, Radboud UMC, Nijmegen, the Netherlands
Michel W.A. Verkroost, MD: Department of Cardio-Thoracic Surgery, Radboud UMC, Nijmegen, the Netherlands
Foeke J. Nauta, MD, PhD: Department of Cardio-Thoracic Surgery, Radboud UMC, Nijmegen, the Netherlands
Wilson L. Li, MD: Department of Cardio-Thoracic Surgery, Radboud UMC, Nijmegen, the Netherlands
Josst A. van Herwaarden, MD, PhD: Department of Vascular Surgery, University Medical Center Utrecht, Utrecht, the Netherlands
Robin H. Heijmen, MD, PhD: Department of Cardio-Thoracic Surgery, Radboud UMC, Nijmegen, the Netherlands

DOI: https://doi.org/10.1016/j.jvscit.2025.101800
Journal volume & issue: Vol. 11, no. 4
p. 101800

Abstract

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We describe a patient treated with thoracic endovascular aortic repair and false lumen (FL) occluder for chronic type B aortic dissection. We noticed during open surgery for contained rupture that the distal unstented sleeve of the FL occluder crossed from the false into the true lumen through an intimal reentry (used for its introduction into the FL) potentially obstructing true lumen-originating renovisceral arteries.

Published in Journal of Vascular Surgery Cases and Innovative Techniques

ISSN: 2468-4287 (Online)
Publisher: Elsevier
Country of publisher: Netherlands
LCC subjects: Medicine: Surgery; Medicine: Internal medicine: Specialties of internal medicine: Diseases of the circulatory (Cardiovascular) system
Website: https://www.journals.elsevier.com/journal-of-vascular-surgery-cases-and-innovative-techniques/

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