title: Repeat endovascular repair for multiple intimal tears after endovascular stent grafting of Stanford type B aortic dissection.
abstract: A 59-year-old man with hypertension was found to have a Stanford type B aortic dissection with a false lumen extending to the abdominal aorta. We placed a stent graft to the thoracic aorta covering the proximal entry and planned a second endovascular repair to cover the entries in the abdominal aorta. Five years later, computed tomography angiography revealed an extensive dissection to the right common iliac artery with multiple intimal tears. We placed stent grafts in the distal end of the primary stent graft and an abdominal stent graft to the aortic bifurcation to cover the entry tears. However, 3 months later it developed into a newly formed intimal tear in the right renal artery, leading to retrograde reperfusion into the false lumen. The patient was successfully treated with a third time endovascular repair and recovered smoothly during follow-up.
authors: Department of Vascular Surgery, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China.
authors: Yangyan
authors: Y
authors: He
authors: Ziheng
authors: Z
authors: Wu
authors: Hongkun
authors: H
authors: Zhang
authors: Donglin
authors: D
authors: Li
authors: Ming
authors: M
authors: Li
authors: Wei
authors: W
authors: Jin
authors: Adel
authors: A
authors: Ai-kalei
mesh_terms: D000784:Aortic Dissection / Q000175:diagnosis / Q000601:surgery*; D017544:Aortic Aneurysm, Abdominal / Q000175:diagnosis / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000175:diagnosis / Q000601:surgery*; D001027:Aortography / Q000379:methods; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects*; D002908:Chronic Disease; D057510:Endovascular Procedures / Q000009:adverse effects*; D006801:Humans; D017543:Iliac Aneurysm / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012077:Renal Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D012086:Reoperation; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome