Use of the frozen elephant trunk technique for type A intramural hematoma

Intramural hematoma (IMH) is a well-recognized type of acute aortic syndrome with a significant rate of progression in more than 60% of cases (1,2). According to the most recent European guidelines, the treatment of a type A IMH follows the same recommendations as for type A aortic dissection (1,3). Therefore, in case of aortic arch involvement, a more radical treatment such as frozen elephant trunk (FET) should be considered. The rationale to use this kind of approach is to prepare for a second stage endovascular procedure, especially in case of distal downstream thoracoabdominal aorta involvement and in young patients. In this video, we illustrate the treatment of a type A IMH using the Vascutek Thoraflex hybrid prosthesis.