Staged endovascular treatment for complicated type B aortic dissection.
BACKGROUND
A 40-year-old man presented with acute chest and back pain, hypertension and anuria. Two years previously he had been diagnosed with acute uncomplicated type B aortic dissection. Following conservative management, with aggressive antihypertensive therapy and analgesia, he was monitored with 6-monthly surveillance CT scans. These demonstrated a complicated type B dissection with renal and iliac malperfusion.


METHODS
Multislice CT, transthoracic and transesophageal echocardiography, digital subtraction aortography.


METHODS
Acute-on-chronic type B aortic dissection, complicated by aneurysmal dilatation of the thoracic aorta and visceral malperfusion.


RESULTS
Antihypertensive therapy; staged thoracoabdominal and branch vessel endoluminal repair (STABLE procedure), with stabilization of the dissection and rescue of renal function; CT imaging surveillance to monitor for any further complications.
Mossop
Peter J
PJ
Department of Cardiology, St Vincent's Hospital, Melbourne, Australia. mossoppj@svhm.org.au
McLachlan
Craig S
CS
Amukotuwa
Shalini A
SA
Nixon
Ian K
IK
D000208:Acute Disease; D000328:Adult; D000784:Aortic Dissection / Q000175:diagnosis / Q000188:drug therapy / Q000601:surgery*; D001013:Aorta, Thoracic / Q000503:physiopathology / Q000601:surgery; D017545:Aortic Aneurysm, Thoracic / Q000175:diagnosis / Q000188:drug therapy / Q000601:surgery*; D001262:Atenolol; D001416:Back Pain / Q000175:diagnosis; D001562:Benzimidazoles; D001713:Biphenyl Compounds; D019917:Blood Vessel Prosthesis Implantation; D002637:Chest Pain / Q000175:diagnosis; D006801:Humans; D008297:Male; D013777:Tetrazoles
D001562:Benzimidazoles; D001713:Biphenyl Compounds; D013777:Tetrazoles; D001262:Atenolol; C081643:candesartan