title: Single-stage repair of a complex type B aortic dissection associated with a pressurized infrarenal abdominal aortic aneurysm.
abstract: The decision-making involved in managing type 2 aortic dissections remains challenging despite the advances in endovascular technology. We report a challenging case of a patient presenting with a type 2 aortic dissection and false lumen extension into an infrarenal abdominal aortic aneurysm (AAA). Severe back pain and hypertension were the patient's initial complaints, and dynamic magnetic resonance angiography revealed 1-way pulsatile flow into the AAA sac from the false lumen. This patient underwent endovascular repair with a thoracic and infrarenal aortic endograft, successfully excluding the false lumen and decompressing the infrarenal aneursymal sac. This is a unique presentation of total endovascular repair of a symptomatic type B aortic dissection with a pressurized infrarenal AAA sac from false lumen flow into the sac.
authors.affiliation: Department of Cardiovascular Surgery, Methodist DeBakey Heart and Vascular Center, The Methodist Hospital, Weill-Cornell Medical College, Houston, TX. Electronic address: mitulspatel@gmail.com.
authors.forename: Mitul S
authors.initials: MS
authors.lastname: Patel
authors.forename: Heitham T
authors.initials: HT
authors.lastname: Hassoun
authors.forename: Mark G
authors.initials: MG
authors.lastname: Davies
authors.forename: Alan B
authors.initials: AB
authors.lastname: Lumsden
mesh_terms: D000369:Aged, 80 and over; D000784:Aortic Dissection / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D017544:Aortic Aneurysm, Abdominal / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D001027:Aortography / Q000379:methods; D001416:Back Pain / Q000209:etiology; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation; D019299:Decompression, Surgical; D057510:Endovascular Procedures / Q000295:instrumentation; D006801:Humans; D006973:Hypertension / Q000209:etiology; D018810:Magnetic Resonance Angiography; D008297:Male; D011673:Pulsatile Flow; D012039:Regional Blood Flow; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome