Use of a physician-modified candy plug to rescue gutter leak arising from a collapsed candy plug

The candy-plug (CP) technique is an option to achieve false lumen occlusion and aortic remodeling in chronic aortic dissection. Gutter leaks are uncommon complications that may necessitate further endovascular or even surgical treatment. We describe a successful reintervention strategy to occlude a massive gutter leak arising from a collapsed, commercially custom-made Cook CP III, achieved using a physician-modified CP device and thereby avoiding surgical repair.