# Endoleak after use of the fenestrated frozen elephant trunk technique to treat acute type A aortic dissection

## TL;DR

A patient developed an endoleak after a fenestrated frozen elephant trunk procedure for aortic dissection, but successful reoperation resolved the issue and reduced aortic arch size.

## Contribution

Highlights the risk of endoleak from fenestrated FET and emphasizes the importance of secure fixation and postoperative monitoring.

## Key findings

- Endoleak from a fenestration site was successfully resolved through reoperation.
- Postoperative monitoring revealed a reduction in aortic arch diameter.
- Secure fixation around fenestrations is critical to prevent endoleak.

## Abstract

Several studies have indicated that the fenestrated frozen elephant trunk (FET) technique enhances early outcomes in cases of acute aortic dissection, although long-term outcomes remain unclear. A case involving a 62-year-old male who experienced endoleak from a fenestration site following total arch replacement using the fenestrated FET technique for a DeBakey type I aortic dissection is reported. The patient underwent successful reoperation involving total arch replacement and reinsertion of the FET. Postoperatively, there was an absence of endoleak from the fenestration, and a noteworthy reduction in the diameter of the aortic arch was observed. It is imperative to recognize that endoleak from a fenestration poses a risk for prompt aortic expansion, thus necessitating vigilant postoperative monitoring. Furthermore, when adopting fenestrated FET, it is crucial to ensure firm fixation around the fenestration to prevent endoleak.