# Stent Graft–Induced New Entry Created at Locations Other Than Both Proximal and Distal Ends

## TL;DR

A rare case of a stent graft causing a new tear in the aorta away from usual locations is reported, emphasizing the need for careful planning in aortic repair procedures.

## Contribution

The paper presents a rare case of SINE occurring at an atypical location within the stent graft's main body.

## Key findings

- SINE can occur in the main body of the stent graft, not just at the proximal or distal ends.
- Endograft oversizing and springback force are potential causes of SINE.
- Careful device selection and procedural planning are essential to prevent SINE.

## Abstract

One of the complications after thoracic endovascular aortic repair (TEVAR) is stent graft–induced new entry (SINE). SINE occurs in 5% to 25% of aortic dissection cases treated with TEVAR and is thought to be associated with endograft oversizing and springback force. Although SINE typically occurs at the proximal or distal ends of the endograft, we report a rare case of managing a SINE formation within the main body of the stent graft, distinct from its landing zones. This unusual presentation highlights the importance of recognizing atypical SINE mechanisms and locations, which can lead to significant complications such as endoleak.

To prevent SINE after TEVAR, it is crucial to consider not only the landing zone and device sizing but also the entire aortic curvature where the stent graft will be deployed. Careful device selection and procedural planning are required.