Figure legends:
Fig. 1 Preoperative computed tomography scan which shows (A) dissection started at the proximal descending aorta. The TL was significantly compressed by the FL. (B) The entry tear was seen in the mid-descending aorta. (C) Right kidney flow was diminished as the TL is significantly compressed. (D) A flow of the Rt. CIA decreased.
TL: True lumen; FL: False lumen; Rt. CIA: Right common iliac artery Fig 2. Intraoperative angiogram demonstrates (A) angiography from the TL. The flow of the CA and the SMA were decreased. (B) The flow in the Rt. RA and the Rt. CIA decreased. (C) A 28 x 109 mm Zenith Alpha Thoracic Endovascular Graft (Cook Medical, Bloomington, Ind) was deployed into the proximal descending aorta covering the primary tear site (Between the red lines). (D) The TL was still compressed from the FL through the visceral arteries segment and infrarenal segment with improved visceral perfusion. (E) After TEVAR and the distal bare metal stent (Between the red lines), the flow of CA and SMA improved. The flow into the FL in the descending aorta disappeared. (F) The flow of Rt. RA and Rt. CIA was clearly seen and the left RA was perfused from the FL. TL: True lumen, FL: False lumen, Rt. RA: Right renal artery, Rt. CIA: Right common iliac artery, CA: Celiac artery, TEAR: Thoracic endovascular aortic repair