title: Endovascular treatment of acute type B dissection complicating aortic coarctation.
abstract: Surgical treatment poses a high risk to patients with concomitant aortic coarctation and dissection, and an interventional approach could be an alternative. We describe the case of a 52-year-old man with a long history of untreated hypertension and aortic coarctation who emergently presented at our institution with an acute Stanford type B dissection. The patient's elevated serum creatinine level, perfusion deficit in the right lower limb, and hypertension did not respond to medical therapy, and he did not consent to surgery. By endovascular means, we used a self-expandable stent-graft to cover the entry point of the dissection; then, we deployed a balloon-expandable bare-metal stent to correct residual stenosis. To our knowledge, this is the first report of the endovascular treatment of aortic coarctation complicated by type B dissection.
authors.affiliation: Department of Interventional Cardiology, Tehran Heart Center, Tehran 1411713138, Iran. ekassaian@yahoo.com
authors.forename: Seyed Ebrahim
authors.initials: SE
authors.lastname: Kassaian
authors.forename: Kyomars
authors.initials: K
authors.lastname: Abbasi
authors.forename: Mehdi
authors.initials: M
authors.lastname: Mousavi
authors.forename: Mohammad
authors.initials: M
authors.lastname: Sahebjam
mesh_terms: D000208:Acute Disease; D000784:Aortic Dissection / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D015901:Angiography, Digital Subtraction; D001014:Aortic Aneurysm / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D001017:Aortic Coarctation / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D001027:Aortography / Q000379:methods; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation; D018618:Echocardiography, Doppler, Color; D017548:Echocardiography, Transesophageal; D057510:Endovascular Procedures / Q000295:instrumentation; D006801:Humans; D008297:Male; D008875:Middle Aged; D015607:Stents; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
keywords: Aneurysm, dissecting/complications; aortic coarctation/complications/therapy; blood vessel prosthesis implantation/methods; endovascular procedures/instrumentation/methods; risk factors; stents; treatment outcome; ultrasonography, interventional