Retrograde type A dissection after endovascular repair of a "zone 0" nondissecting aortic arch aneurysm

Retrograde type A dissection (RTAD) is not so uncommon after thoracic endovascular aortic repair of type B dissections, especially in the presence of connective tissue disorders. Risk of RTAD after thoracic endovascular aortic repair of nondissecting aneurysms has still to be clarified, mainly if proximal arch involvement requires hybrid repair with ascending aortic side clamping, supra-aortic trunks proximal re-routing and endograft landing in ascending aorta. We report a mid-term RTAD after hybrid repair of a proximal arch nondissecting aneurysm without connective tissue disorders. The technique for ascending aortic replacement without arch endograft removal and literature review about this poorly known complication are presented. © Annals of Vascular Surgery Inc.