[Urgent endovascular management of the thoracic aorta dissection and subsequent lower extremity ischemia].
BACKGROUND
Insertion of tubular stentgrafts in the management of acute type B dissection of the thoracic aorta has recently become a popular alternative to open surgeries. The classical surgical procedure in complicated dissections is associated with mortality rates of up to 50% and prolonged intensive care hospitalization. However, endovascular procedures have been associated with significantly lower morbidity and mortality rates. There is insufficient experience with the stentgraft implantation outcome concerning both the septum dissection and the lumini.


METHODS
A tubular stentgraft has been implanted to a forty-nine-year-old patient with acute, type B dissection. Immediate ischemic and neurological complications, requiring reoperation and prolonged intensive care, were recorded postoperatively. The causes and the management are discussed.


CONCLUSIONS
Endovascular management of the type B dissection is a popular, more patient-saving and healthcare professionals-saving procedure, compared to classical open surgery. Pressure changes in the true and false aortic lumen may result in rapid reduction of the organ and limb perfusion flow. These complications should be expected and must be managed urgently. Such surgeries should be performed in clinical centres with appropriate facilities.
Sedivý
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P
Oddelení cévní chirurgie, Nemocnice Na Homolce, Praha. petr.sedivy@homolka.cz
Sebesta
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Mach
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D000784:Aortic Dissection / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation; D004630:Emergencies; D006801:Humans; D007511:Ischemia / Q000209:etiology* / Q000601:surgery; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D015607:Stents; D014656:Vascular Surgical Procedures / Q000009:adverse effects*