# New approach to type B aortic dissection – zone 2.5 thoracic endovascular aortic repair: a case report

## TL;DR

A new TEVAR technique for type B aortic dissection uses the left subclavian artery wall as a sealing zone, showing successful outcomes in a patient with limited options.

## Contribution

A novel TEVAR technique using the LSA wall as a sealing zone for zone 2 landing in type B aortic dissection.

## Key findings

- The technique achieved complete coverage of the entry tear and false lumen thrombosis.
- Postoperative CT showed preserved left subclavian perfusion and favorable remodeling.
- The patient recovered uneventfully and was discharged on day 8.

## Abstract

We report a novel thoracic endovascular aortic repair (TEVAR) technique for complicated type B aortic dissection requiring zone 2 landing. A 42-year-old man presented with pulseless left femoral artery. Emergency TEVAR was performed using the left subclavian artery (LSA) wall as a sealing zone to reduce the risk of endoleak. Postoperative recovery was uneventful, and the patient was discharged on day 8. CT demonstrated complete coverage of the entry tear, false lumen thrombosis, and preserved left subclavian perfusion. Follow-up CT showed favorable remodeling. This technique may be effective in patients with limited proximal sealing zones.

The online version contains supplementary material available at 10.1186/s13019-025-03828-6.