Looping wire technique to facilitate true lumen wiring during TEVAR in type B aortic dissection with aneurysmal degeneration: A case report

Introduction and importance: Wiring true lumen during Thoracic Endovascular Aortic Repair (TEVAR) is sometimes difficult in complicated Type B Aortic Dissection (TBAD). Case presentation: We treated a TBAD patient with large false lumen, compressed true lumen and multiple entries. After repeated wire misdirection to false lumen, we tried a new technique in which the wire in the false lumen was looped after entrance to true lumen and pushed distally. The looped wire was then used as guide to advance a second wire to the ascending aorta. TEVAR could then be completed with good result. Discussion: Wiring the true lumen might be one of the most challenging steps during TEVAR in complicated TBAD. Several methods have been used to overcome the problems, but the cost and availability might be a problem in some countries. The looping wire technique may serve as an alternative method of guiding the process of wiring the true lumen during complicated TEVAR. Conclusion: Looping wire technique can be used as an alternative method to facilitate true lumen wiring during TEVAR.