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

Persistent retrograde false lumen (FL) flow is a common complication following thoracic endovascular aortic repair (TEVAR) for type B aortic dissections. The candy plug technique is a well-established method for FL exclusion; however, device availability can be a limiting factor. We report the case of a 57-year-old man who underwent a novel FL exclusion procedure 2 days post-TEVAR, using a 36 × 66 mm Cook Converter graft and Amplatzer plugs, with complete FL thrombosis and resolution of hemothorax on imaging 7 weeks postoperatively. This off-label technique offers a viable alternative when commercially available candy plug devices are unavailable and urgent intervention is required.