title: Type A aortic dissection developing during endovascular repair of an acute type B dissection.
abstract: OBJECTIVE
  To describe an extension of type B dissection into type A during endoluminal treatment of acute type B dissection.
  
  
  METHODS
  A 57-year-old man with acute type B dissection underwent endovascular repair using 2 Excluder stent-grafts. Before releasing the second stent-graft, the patient complained of mild central chest pain, headache, and visual flashes, but no hemodynamic changes were noticed. An angiogram, performed soon afterwards, showed a retrograde extension of the dissection through the aortic arch involving both the left carotid artery and the ascending aorta. The procedure was completed, and the patient was transported to the operating room where the proximal ascending aorta was replaced. Spiral computed tomographic angiography performed 2 weeks after the procedure showed complete exclusion of the primary entry tear. At 6-month follow-up, the patient was asymptomatic; the left carotid artery dissection had disappeared.
  
  
  CONCLUSIONS
  Endovascular repair of acute type B dissection is technically feasible, but longer experience will help prevent technical complications.
authors.affiliation: Department of Radiological Sciences, University of Rome La Sapienza, Rome, Italy. fabrizio.fanelli@uniroma1.it
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Fanelli
authors.forename: Filippo Maria
authors.initials: FM
authors.lastname: Salvatori
authors.forename: Giulia
authors.initials: G
authors.lastname: Marcelli
authors.forename: Mario
authors.initials: M
authors.lastname: Bezzi
authors.forename: Marco
authors.initials: M
authors.lastname: Totaro
authors.forename: Simone
authors.initials: S
authors.lastname: Vagnarelli
authors.forename: Michael D
authors.initials: MD
authors.lastname: Dake
authors.forename: Plinio
authors.initials: P
authors.lastname: Rossi
authors.forename: Roberto
authors.initials: R
authors.lastname: Passariello
mesh_terms: D000784:Aortic Dissection / Q000601:surgery*; D017130:Angioplasty / Q000009:adverse effects*; D017545:Aortic Aneurysm, Thoracic / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects*; D006801:Humans; D007431:Intraoperative Complications; D008297:Male; D008875:Middle Aged; D015607:Stents / Q000009:adverse effects*