ArticleJournal of vascular surgery cases and innovative techniques2023
Initial experience with a modified "candy-plug" technique for false lumen embolization in chronic type B aortic dissection.
Article in Journal of vascular surgery cases and innovative techniques, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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9 citing papers in PubMed, 12 citations in OpenAlex.
- Thermal septotomy complications and management of residual septum visceral ostial occlusions.Journal of vascular surgery cases and innovative techniques · 2026Article
- A physician-modified endograft for intercostal arteries preservation and its role as an endovascular strategy in chronic aortic dissection.Journal of vascular surgery cases and innovative techniques · 2026Article
- Black candy-plug technique for a large false lumen in a patient with complicated type B aortic dissection.Journal of vascular surgery cases and innovative techniques · 2026Article
- A novel off-the-shelf solution for the treatment of retrograde false lumen flow causing hemothorax after thoracic endovascular aortic repair for aortic dissection and rupture.Journal of vascular surgery cases and innovative techniques · 2026Article
- Thoracic Endovascular Aortic Repair.Annals of vascular diseases · 2026Review
- Controversies in Chronic Aortic Dissection.Seminars in interventional radiology · 2024Review
- Transcatheter electrosurgical aortic septostomy optimizes distal landing zone in chronic dissection.JTCVS techniques · 2024Article
- Plug-Based Embolization Techniques of Aortic Side Branches during Standard and Complex Endovascular Aortic Repair.Journal of clinical medicine · 2024Review
- Candy-plug: Failure to launch.Journal of vascular surgery cases and innovative techniques · 2023Article
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Authors and funding
9 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Persistent distal false lumen (FL) perfusion after thoracic endovascular aortic repair (TEVAR) for type B aortic dissection (TBAD) can lead to aneurysmal degeneration and an increased risk of rupture. We have presented our initial experience using a modified "candy-plug" (CP) technique for FL embolization. Methods: From February 2021 to July 2022, we treated six patients using the modified CP technique. All the patients had undergone prior or simultaneous TEVAR for chronic TBAD with persistent FL perfusion and aneurysm expansion. Bilateral common femoral artery access was obtained, and intravascular ultrasound was used to confirm wire access in the true lumen (TL) and FL. A conformable TAG device (W.L. Gore & Associates, Flagstaff, AZ) was used in four cases and an Excluder aortic cuff (W.L. Gore & Associates) in two cases. The device was modified by placing a constraining "napkin-ring" suture through the middle segment of the device. Femoral sheaths were placed in the TL and FL. A standard TL TEVAR extension was performed at the level of the celiac artery (zone 5). Next, the CP device was advanced and deployed in the FL, distally aligning it with the TL device. An appropriately sized Amplatzer II plug (Abbot Vascular, Santa Clara, CA) was then deployed in the constrained segment of the modified stent graft. Completion angiography was performed to confirm successful FL embolization. Results: Technical success was defined as successful deployment of the CP device in the FL. The technical success rate was 100% (six of six patients). Clinical success was defined as the cessation of aneurysm growth on follow-up computed tomography angiography. No 30-day mortality, myocardial infarction, stroke, spinal cord ischemia, access site complications, or aortic-related reinterventions occurred. Surveillance imaging at a mean follow-up of 10 months confirmed clinical success (stable aneurysm size or shrinkage) for all five patients with follow-up data available. Conclusions: The modified CP embolization technique is a promising solution for persistent distal FL perfusion after TEVAR for TBAD. Further investigation is required to determine the long-term durability of this technique as an adjunct to TEVAR to promote aortic remodeling.
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