Although endovascular treatment of the thoracic aorta (TEVAR) has become an elective procedure for treatment of complicated type B aortic dissection, its role in treating post dissection thoraco-abdominal aortic aneurysm (TAAA), is still limited. This is a case of aortic vascular disease, which reports the use of a new endovascular device. : We present the case of a 62 year old male patient with a history of hypertension, active smoker, who presented penetrating descending thoracic aortic ulcer in the setting of a chronic abdominal aortic dissection. The patient was treated using a new stent graft capable of in situ fenestration that allowed crossing the stent-graft membrane, implanting a covered stent to exclude the re-entry at the level of the left renal artery and redirecting the blood flow through the true lumen. This case report demonstrates the feasibility of a novel stent-graft concept. Larger studies with longer follow-up are essential to fully evaluate the safety and effectiveness of this new design.

中文翻译：

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慢性腹主动脉夹层，使用新型支架植入物进行原位开窗的血管内治疗

尽管胸腔主动脉（TEVAR）的血管内治疗已成为治疗复杂的B型主动脉夹层的选择性方法，但其在解剖后胸腹主动脉瘤（TAAA）中的作用仍然有限。这是主动脉血管疾病的情况，其报道了使用新的血管内装置。：我们介绍了一例具有高血压病史，活跃吸烟者的62岁男性患者，该患者在慢性腹主动脉夹层中表现出穿透性降主动脉溃疡。使用能够原位开窗的新型支架移植物治疗该患者，该支架能够穿过支架移植物膜，植入覆盖支架以排除左肾动脉水平的再次进入，并重新引导血流通过真正的管腔。该案例报告证明了新型支架植入概念的可行性。较大的研究和更长的随访对于全面评估这种新设计的安全性和有效性至关重要。