The Fabulous® stent system facilitates complete false lumen remodelling mainly with bare stent components in treating acute Stanford type B aortic dissection: a case report.

BACKGROUND: Stanford type B aortic dissection typically involves the distal part of the aorta, with covering the proximal tear being sufficient for treatment in the majority of these patients. The real challenge arises in cases with severely compressed true lumen, where implanting only the proximal stent-graft is insufficient to dilate the visceral segment of the aorta and the distal true lumen. CASE SUMMARY: A 58-year-old male patient was admitted to our centre due to acute type B aortic dissection for 3 days. Contrast-enhanced computed tomography angiography (CTA) revealed the dissection had continuously extended downward to the right iliac artery, and the true lumen of the distal aorta was compressed close to occlusion at the visceral artery level. The Fabulous® stent system was applied in this case, with a covered stent sealing the proximal entry, and two self-expanding, anti-compression bare stents expanding the true lumen. Postoperative CTA showed satisfactory aortic remodelling, with the true lumen fully opening and the false lumen completely disappearing. DISCUSSION: This integrally designed stent system of combining a self-expanding, anti-compression bare stent with a covered stent graft effectively addresses the issue of acute type B aortic dissection with a severely compressed true lumen of the visceral aortic segment. By utilizing modularized bare stents with an appropriate mesh diameter to expand the distal aorta, it sufficiently promotes aortic remodelling. At the same time, the stent system provides adequate branch arterial blood flow, effectively reducing the risk of severe complications such as paraplegia and renal failure.