Treatment of retrograde ascending aorta and aortic arch intramural hematoma (IMH) with thoracic endovascular aortic repair (TEVAR)

Typically, the presence of ascending aortic IMH is treated with open surgical repair due to the unpredictability of subsequent rupture. We demonstrate successful endovascular management of retrograde ascending IMH with TEVAR in a 58-year-old, high-risk patient. Assisted by high-quality pre- and intra-operative imaging, TEVAR for type B dissection with retrograde IMH extension into the ascending aorta may offer a less invasive treatment and possibly a better outcome for patients.