Underlying mechanism and preventive measures of distal stent graft-induced new entry after thoracic endovascular aortic repair for Stanford type B aortic dissection

Abstract

Distal stent graft-induced new entry (dSINE) is the complication with high incidence following thoracic endovascular aortic repair (TEVAR) for Stanford type B aortic dissection. This review the underlying mechanism and preventive measures regarding dSINE. General mechanism include: the fragile state of dissected aortic wall and intimal flap is pathophysiologic foundation of dSINE; the continued resistive force to the deformation of stent-graft is mechanical cause of intimal injury; the intimal flap movement within a cardiac cycle result in local damage accumulation in distal site of stent-graft. Aortic remolding play an important role in prophylaxis of dSINE.