Endoluminal repair of infrarenal AAA in the presence of aortic dissection.
OBJECTIVE
To report a challenging case of infrarenal abdominal aortic aneurysm (AAA) treated with a commercial stent-graft in the face of thoracoabdominal aortic dissection.


METHODS
A 73-year-old patient was admitted because of acute descending thoracic and abdominal aortic dissection. He was also found to have an 8-cm infrarenal AAA. After initial medical management of the acute aortic dissection, the patient underwent endoluminal AAA repair with an AneuRx stent-graft. The completion angiogram showed that the graft was deployed in the false lumen; this complication was treated with fenestration of the intimal flap, establishing flow through both lumens. The patient's recovery was uneventful, and he was discharged on the fourth postoperative day. Follow-up at 1 year with computed tomographic angiography documented a stable descending thoracic aorta with a suggestion of a type II endoleak and no change in the aneurysm volume.


CONCLUSIONS
This case illustrates the feasibility of endograft repair of infrarenal AAA with a modular stent-graft in the presence of aortic dissection extending below the renal arteries.
Tefera
Girma
G
University of Wisconsin Hospital & Clinics, Madison, Wisconsin, USA. tefera@surgery.wisc.edu
Carr
Sandra
S
Hoch
John
J
Acher
Charles W
CW
Turnipseed
William D
WD
D000368:Aged; D000784:Aortic Dissection / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery*; D017130:Angioplasty; D017544:Aortic Aneurysm, Abdominal / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery*; D001027:Aortography; D019917:Blood Vessel Prosthesis Implantation; D006801:Humans; D008297:Male; D015607:Stents