The patient was a 67-year-old man presented to the emergency department with severe chest pain. Computed tomography showed a type B aortic dissection extending from the left subclavian artery to the iliac bifurcation. 

After 2 weeks of medical treatment, CT showed a near total occlusion of the left renal artery and decreased enhancement of left renal parenchyma due to static extension of dissection flap into the left renal artery. Consideringthat the patient had a complicated type B aortic dissection, Thoracicendovascular aortic repair was planned following heart-team discussion.

The procedure was planned to use a Valiant stent of size 38-34-150 (Medtronic, MN,USA). A pig tail catheter was placed in the ascending aorta through the left radial artery. To reduce the possibility of the wire entering the false lumen, an introducing catheter was inserted into the right femoral artery because the intimal flap involvement of the common iliac artery was minimal, intravascular ultrasound was used to confirm that the wire was located in the true lumen. Stent was implanted successfully without procedural complication. The patient remained asymptomatic during 2-year follow-up period, and CT showed that false lumen enhancement in the abdominal aorta, but decreased size and thrombosis of false lumen of the thoracic aorta.

Currently, the standard treatment for type B aortic dissection is medical treatment. However, for some patients, including those with complicated type B aortic dissection, thoracic endovascular repair may also be a good treatment option.