SINE is an uncommon late complication of the endovascular treatment of aortic dissections with high mortality rates . It can occur either at the proximal or distal end of the stent [2, 3]. SINE, which was first reported by Kato et al.  in 2001 as an aneurysmal degeneration of the aorta after TEVAR for acute aortic dissection, is one of the serious and specific complications. Risk factors of SINE may include the oversizing of the stent graft, the radial force of an oversized stent graft or an already diseased intima . By generalizing the past researches, Wadi concluded that the etiology of SINE was likely related to the radial force of an oversized stent graft, the oversizing of the stent graft, intrinsic intimal weakness, a false lumen remodeling, or natural progression of the aortic disease . Thus, the reintervention for SINE can excavate new entry around the aorta and avoid the aortic rupture. The treatment of proximal and distal SINE had been reported in previous clinical cases [6,7,8]. Some researchers had suggested that the risk of paraplegia could be significantly reduced by preserving as many intercostal arteries as possible [9, 10]. It was worth to be considered to avoid potential complications induced by paraplegia due to the long frame coverage area [9,10,11]. Meanwhile, the vascular true-lumen could be open up as much as possible. Given above concerns, these two stent-grafts were non-overlapped and the intercostal artery was preserved in the T7-L2 segment of the descending aorta.
To our knowledge, it is the first-reported case of the two non-overlapping stent-grafts of SINE treated by re-TEVAR. Frankly, we would not deny that the original TEAVR might be a failed operation, but the results are satisfactory after re-TEVAR. The SINE between two non-overlapping stent-grafts was treated successfully and the descending aorta was well recovered by re-TEVAR. No paraplegia was observed after re-TEVAR. It will be an ideal option for patients to suffer from less risk of cardiopulmonary bypass and deep hypothermia circulatory arrest.
As one of the complications after TEVAR, SINE may be more dangerous than TBAD itself, the SINE between two non-overlapping stent-grafts treated by re-TEVAR operation is alternative and feasible. The short-term and medium-term follow-up results are satisfactory.