Emergency endovascular repair of acute descending thoracic aortic dissection.
BACKGROUND
Acute descending thoracic aortic dissection is a life-threatening emergency. It is not often considered as the initial diagnosis in patients presenting with epigastric pain and could easily be missed in a busy casualty department.


OBJECTIVE
This case report is aimed to highlight the feasibility of the technique and the need for long-term surveillance following endovascular repair of acute thoracic aortic dissection.


RESULTS
The patient presented with epigastric pain radiating to the interscapular region with a stable hemodynamic status. A computerized tomography (CT) scan demonstrated type B thoracic aortic dissection of the proximal descending thoracic aorta. A successful endovascular repair was carried out with uneventful recovery and follow-up CT scan six years after stent-grafting shows satisfactory position of the stent-graft, patent false lumen in the abdominal aorta perfusing the right kidney, and progressively enlarging diameter of the abdominal aorta.


CONCLUSIONS
Thoracic aortic dissection should be considered as a differential diagnosis in patients presenting with epigastric and interscapular chest pain. Emergency endovascular repair of acute thoracic aortic dissection is feasible and relatively safe. Regular follow-up with CT scan is required to evaluate the long-term efficacy and identify the need for re-intervention.
Sharif
Muhammad Anees
MA
Department of Vascular and Endovascular Surgery, Royal Victoria Hospital, Belfast, United Kingdom. aneessharif@yahoo.co.uk
O'Donnell
Mark Edward
ME
Blair
Paul Henry
PH
Kennedy
Peter
P
D000208:Acute Disease; D000784:Aortic Dissection / Q000473:pathology / Q000601:surgery*; D000792:Angiography; D017545:Aortic Aneurysm, Thoracic / Q000473:pathology / Q000601:surgery*; D004632:Emergency Medical Services; D005260:Female; D006801:Humans; D008833:Microcirculation / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D014057:Tomography, X-Ray Computed