Journal: Journal of Vascular Surgery Cases, Innovations and Techniques

Article Title: Black candy-plug technique for a large false lumen in a patient with complicated type B aortic dissection

doi: 10.1016/j.jvscit.2026.102212

Figure Lengend Snippet: Under intravascular ultrasound (IVUS) guidance, the dissection flap was punctured from the true lumen into the false lumen (FL) approximately 2 cm distal to the caudal end of the thoracic stent graft, and a Radifocus guidewire was advanced into the FL (A) . The fenestration was then dilated using an 8 mm × 4 cm balloon catheter (B) . The modified Excluder aortic extender (Ex-cuff) was deployed at the distal level of the thoracic stent graft (C) . Subsequently, a 16-mm Amplatzer Vascular Plug I, preloaded with a 2.2F microcatheter was deployed at the waist of the modified Ex-cuff (D) . The microcatheter was then withdrawn into the plug, and four detachable coils were placed within the plug (E and F) . Angiography revealed persistent perigraft leakage around the Ex-cuff (G) . Therefore, 33% n-butyl-2-cyanoacrylate (NBCA) was slowly injected, achieving complete occlusion (H) ( arrowhead , coil-in-plug; arrow , NBCA-Lipiodol). Completion angiography confirmed complete elimination of FL perfusion in the thoracic aortic segment (I) .

Article Snippet: Subsequently, a 16-mm Amplatzer Vascular Plug I (Abbott), preloaded with a 2.2F-microcatheter (Coiling Support, HI-LEX Co) was delivered through a 6F guiding catheter (Destination; Terumo Medical Co) and deployed at the waist of the modified Ex-cuff ( , D ).

Techniques: Dissection, Modification, Injection