{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T03:39:39Z","timestamp":1793417979385,"version":"4.5.0"},"reference-count":14,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2022,7,21]],"date-time":"2022-07-21T00:00:00Z","timestamp":1658361600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Endovasc Ther"],"published-print":{"date-parts":[[2024,2]]},"abstract":"\n Purpose:<\/jats:title>\n Unintended false-lumen thoracic endovascular aortic repair (TEVAR) is under-reported and often fatal. We present percutaneous endovascular rescue techniques for true-lumen reperfusion with strategies to address the peripheral artery perfusion needs unique to each case.<\/jats:p>\n <\/jats:sec>\n \n Case Report:<\/jats:title>\n Two patients deteriorated 24 hours after uncomplicated and complicated acute aortic type-B dissection TEVAR treatment at a tertiary community hospital. Reevaluation of index and repeated imaging studies revealed inadvertent false-lumen TEVAR with severe visceral and peripheral ischemia. Stepwise subtraction angiography was used to confirm continuous true-lumen catheterization from femoral puncture into the thoracic aorta. Retrograde fenestration distal to the misplaced TEVAR from the true- into the false-lumen allowed for snorkeling by distal stent-extension across the dissection membrane. In one case, TEVAR stent graft extension resulted in true-lumen re-expansion and in the other case, bare-metal stent-extension for stabilization of the dissection membrane resulted in true-lumen re-expansion in addition to preservation of visceral and peripheral perfusion via the false-lumen. Despite excellent acute hemodynamic results and initial signs of recovery, both patients eventually died (multiorgan failure; cerebral hemorrhagic infarction).<\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n Correct indication and prompt recognition of potential inadvertent false-lumen stenting is critical to avoid disastrous sequelae, for example, malperfusion. Endovascular salvage is feasible for restoration of correct perfusion and must be performed in a timely manner.<\/jats:p>\n <\/jats:sec>\n \n Clinical Impact<\/jats:title>\n Clinically apparent, complicated type-B dissection necessitates instantaneous treatment. Prerequisite for an endovascular approach is a true-lumen guidewire continuously from access to the ascending aorta. DSA after TEVAR and prompt clinical re-evaluation are to verify effective visceral and peripheral restoration of blood flow. Despite these measures, inadvertent false-lumen TEVAR may occur rarely. Immediate recognition may allow for timely true-lumen re-expansion using percutaneous endovascular salvage techniques e.g. retrograde fenestration from the true- into the false-lumen for distal snorkeling of the misplaced TEVAR across the dissection membrane. However, morbidity and mortality are very high, if erroneous stent graft placement is not identified early.<\/jats:p>\n <\/jats:sec>","DOI":"10.1177\/15266028221112259","type":"journal-article","created":{"date-parts":[[2022,7,21]],"date-time":"2022-07-21T08:41:46Z","timestamp":1658392906000},"page":"151-156","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":8,"title":["Endovascular Rescue Aortic Fenestration After Accidental False Lumen TEVAR in Type B Dissection"],"prefix":"10.1177","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5510-653X","authenticated-orcid":false,"given":"Alexander","family":"Massmann","sequence":"first","affiliation":[{"name":"Clinic for Diagnostic and Interventional Radiology, Saarland University Medical Center, Homburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5367-6819","authenticated-orcid":false,"given":"Christian","family":"Giebels","sequence":"additional","affiliation":[{"name":"Clinic for Thoracic and Cardiovascular Surgery, Saarland University Medical Center, Homburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arno","family":"Buecker","sequence":"additional","affiliation":[{"name":"Clinic for Diagnostic and Interventional Radiology, Saarland University Medical Center, Homburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans-Joachim","family":"Sch\u00e4fers","sequence":"additional","affiliation":[{"name":"Clinic for Thoracic and Cardiovascular Surgery, Saarland University Medical Center, Homburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Fries","sequence":"additional","affiliation":[{"name":"Clinic for Diagnostic and Interventional Radiology, Saarland University Medical Center, Homburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2022,7,21]]},"reference":[{"issue":"4","key":"bibr1-15266028221112259","first-page":"351","volume":"3","author":"Gargiulo M","year":"2014","journal-title":"Ann Cardiothorac Surg"},{"key":"bibr2-15266028221112259","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2014.07.053"},{"key":"bibr3-15266028221112259","doi-asserted-by":"publisher","DOI":"10.1177\/1526602818759756"},{"key":"bibr4-15266028221112259","doi-asserted-by":"crossref","DOI":"10.1016\/j.athoracsur.2007.10.099","volume":"85","author":"Svensson LG","year":"2008","journal-title":"Ann Thorac Surg"},{"key":"bibr5-15266028221112259","doi-asserted-by":"publisher","DOI":"10.1148\/rg.251045078"},{"key":"bibr6-15266028221112259","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.104.525972"},{"key":"bibr7-15266028221112259","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2014.11.072"},{"key":"bibr8-15266028221112259","doi-asserted-by":"publisher","DOI":"10.12998\/wjcc.v8.i5.954"},{"key":"bibr9-15266028221112259","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvscit.2020.08.008"},{"key":"bibr10-15266028221112259","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2016.12.039"},{"key":"bibr11-15266028221112259","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvscit.2019.07.011"},{"key":"bibr12-15266028221112259","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2015.10.083"},{"key":"bibr13-15266028221112259","doi-asserted-by":"publisher","DOI":"10.1093\/icvts\/ivaa043"},{"issue":"3","key":"bibr14-15266028221112259","first-page":"598","volume":"57","author":"Raupach J","year":"2020","journal-title":"Eur J Cardiothorac Surg"}],"container-title":["Journal of Endovascular Therapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15266028221112259","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/15266028221112259","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15266028221112259","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T21:34:54Z","timestamp":1777498494000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/15266028221112259"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,7,21]]},"references-count":14,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2024,2]]}},"alternative-id":["10.1177\/15266028221112259"],"URL":"https:\/\/doi.org\/10.1177\/15266028221112259","relation":{},"ISSN":["1526-6028","1545-1550"],"issn-type":[{"value":"1526-6028","type":"print"},{"value":"1545-1550","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,7,21]]}}}