Endovascular repair of residual intimal tear or distal new entry after frozen elephant trunk for type A aortic dissection

With advances in the surgical techniques and availability of ‘frozen elephant trunk’ (FET) prostheses, more and more centers have adopted the technique of FET and total aortic arch replacement in the management of patients with type A aortic dissection (TAAD). However, following the FET repair, late complications requiring reoperations may still occur (1,2). These are often related to residual intimal tear, new entry or aortic dilation distal to the FET in the descending thoracic aorta. After surgical aortic repair, a residual entry tear may lead to a patent false lumen in the downstream aorta, which will significantly affect long-term prognosis with decreased survival and increased distal aortic events (3-5). Reports on such patients in large series with longer follow-ups are scarce, especially regarding management of distal new entry tear (4,6)