Jumping lumens, A case of mesenteric ischemia after thoracic endovascular aortic repair for type B aortic dissection

We report a case of mesenteric ischemia after thoracic endovascular aortic repair (TEVAR) for chronic type B aortic dissection performed at a different institution. Computed tomography angiography findings indicated that the previous TEVAR had been deployed distally into the false lumen. To mitigate this, a large fenestration was created between the false lumen and true lumen. This was then followed by distal extension of the original TEVAR to improve the distal seal. Intravascular ultrasound examination was used to differentiate between the true and false lumens, as well as evaluate the status of branch vessels intraoperatively. This case illustrates the importance of intravascular ultrasound examination in providing real-time feedback to ensure optimal outcomes during complex procedures.