Relief of mesenteric ischemia in type III aortic dissection with percutaneous fenestration of the aortic septum.
Subacute mesenteric ischemia developed 2 months after initial presentation in a patient with a type III aortic dissection. Percutaneous transfemoral fenestration of the septum between the true and false lumens resulted in resolution of clinical, angiographic, and manometric signs of ischemia. Continued expansion of the false lumen required aortic resection and graft replacement of the distal thoracic and abdominal aorta 2 months after the fenestration procedure. At operation, the fenestration site appeared as a 2-cm horizontal tear in the aortic septum, free of adherent thrombus and unrelated to expansion of the false lumen.
Williams
D M
DM
Department of Radiology, University Hospitals, University of Michigan, Ann Arbor 48109.
Brothers
T E
TE
Messina
L M
LM
D000784:Aortic Dissection / Q000601:surgery / Q000628:therapy*; D000800:Angioplasty, Balloon; D001013:Aorta, Thoracic / Q000601:surgery; D001014:Aortic Aneurysm / Q000601:surgery / Q000628:therapy*; D001807:Blood Vessel Prosthesis; D002404:Catheterization; D005263:Femoral Artery / Q000601:surgery; D006801:Humans; D008297:Male; D008638:Mesenteric Arteries; D008641:Mesenteric Vascular Occlusion / Q000628:therapy*; D008875:Middle Aged