To evaluate the secondary endoluminal treatment and medium-term efficacy of dissection involving the branch of the abdominal aorta after aortic repair.

From November 2020 to August 2021, patients with dissection involving abdominal visceral branches resulting in the prosthetic cavity gradually enlarging and organ ischemia after primary endovascular repair were selected for secondary endovascular treatment, and a total of 18 patients were retrospectively collected, with an average age of 40.05 ±3.45 years old between 29 and 60 years old. The interval between the primary and second stages of operation ranges from 14 days to 8 months. The second stage of intraluminal treatment includes: chest, abdominal aorta, and abdominal branch covering stent implantation, pseudo-cavity coil embolism, etc. Imaging data were collected from 6 to 15 months after operation, and the DSA was reviewed immediately during operation, and the CT performance of patients was followed up from 6 to 15 months after operation.

All patients successfully completed endoluminal treatment. A total of 19 thoracic and abdominal aortic mulching stents were implanted in 18 patients, with a diameter of 20~28 mm and a length of 80 mm, and 20 covered stents were implanted in the branch of the abdominal artery, including 10 covered stents of right renal artery,7 of left renal artery, 2 of peritoneal trunks, 1 of upper mesenteric artery, and 5 cases of pseudo-cavity coil embolism. Follow-up evaluation of true and false cavity reconstruction and organ blood supply in 18 cases, including excellent (40%), better (50%), improvement (10%). The patency rate of the covered stent of the abdominal visceral branches was 100%.

The secondary endovascular treatment of aortic dissection involving the branch of the abdominal artery after primary endovascular repair is safe and effective, and some patients can achieve clinical cure, which effectively promotes the development of true and false cavity reconstruction in a favorable direction.