Aortic intimal dehiscence: a complication of percutaneous balloon fenestration for aortic dissection.
A patient with acute type B dissection and a tube configuration of the intimal flap presented with signs of advanced mesenteric and renal ischemia as well as decreased pulses in the lower extremities. The patient was referred for emergency percutaneous fenestration of the abdominal aorta as a salvage procedure and a possible bridge to later surgery. After fenestration, femoral pulses became transiently stronger and then disappeared. The patient died after exploratory laparotomy. Postmortem examination demonstrated dehiscence of the infrarenal abdominal aortic intima with occlusion of the aortic bifurcation.
Lookstein
R A
RA
Department of Radiology, Box 1234, Mount Sinai NYU Health, Mount Sinai Medical Center, One Gustave L. Levy Place, New York, New York 10029, USA. looksro1@doc.mssm.edu
Mitty
H
H
Falk
A
A
Guller
J
J
Nowakowski
F S
FS
D000208:Acute Disease; D000784:Aortic Dissection / Q000150:complications* / Q000000981:diagnostic imaging; D001012:Aorta, Abdominal / Q000293:injuries*; D001014:Aortic Aneurysm / Q000150:complications* / Q000000981:diagnostic imaging; D002404:Catheterization / Q000009:adverse effects*; D017809:Fatal Outcome; D006801:Humans; D007511:Ischemia / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D007668:Kidney / Q000098:blood supply; D007866:Leg / Q000098:blood supply; D008297:Male; D008643:Mesentery / Q000098:blood supply; D008875:Middle Aged; D015641:Radiography, Interventional