New approach to type B aortic dissection – zone 2.5 thoracic endovascular aortic repair: a case report

We report a novel thoracic endovascular aortic repair (TEVAR) technique for complicated type B aortic dissection requiring zone 2 landing. A 42-year-old man presented with pulseless left femoral artery. Emergency TEVAR was performed using the left subclavian artery (LSA) wall as a sealing zone to reduce the risk of endoleak. Postoperative recovery was uneventful, and the patient was discharged on day 8. CT demonstrated complete coverage of the entry tear, false lumen thrombosis, and preserved left subclavian perfusion. Follow-up CT showed favorable remodeling. This technique may be effective in patients with limited proximal sealing zones.