Introduction:
Total Arch Replacement (TAR) using a Frozen Elephant Trunk (FET) is
performed for chronic type B aortic dissection, with reported successful
thrombosis of the false lumen. However, when distal stent graft-induced
new entry (dSINE) occurs in the postoperative period, the blood flow
within the false lumen remains unclear. In this study, 4D flow MRI was
employed for blood flow evaluation in dSINE cases, providing actual
measurements of flow velocity and direction, unlike contrast-enhanced CT
simulations. Accelerated flow from the true lumen to the false lumen was
confirmed, along with an increase in WSS within the false lumen,
predicting future enlargement. Consequently, TEVAR was performed for
dSINE, resulting in favorable rethrombosis of the false lumen.