Treatment of visceral malperfusion in acute type B aortic dissection by percutaneous endovascular fenestration using a stent, with additional stenting of the true lumen.
Patients with acute type B aortic dissection (ABAD) are often treated medically. However, ABAD is a potentially serious emergency if complicated by acute organ ischemia. The therapeutic strategy for ABAD with visceral malperfusion remains controversial. Because emergent surgery has a high mortality rate, emergent endovascular treatment can be performed instead. We report a case of endovascular fenestration with stenting for visceral malperfusion in ABAD. One stent was inserted across the intimal flap to keep the fenestrated site open, and another stent was placed into the narrowed true lumen. This therapeutic strategy may be feasible for ABAD with acute malperfusion.
Division of Intensive and Cardiovascular Care Unit, Nippon Medical School Hospital.
Hideki
H
Miyachi
Shiro
S
Onozawa
Koichi
K
Akutsu
Wataru
W
Shimizu
Shin-Ichiro
S
Kumita
Keiji
K
Tanaka
Satoru
S
Murata
D000784:Aortic Dissection / Q000601:surgery*; D001014:Aortic Aneurysm / Q000601:surgery*; D004630:Emergencies; D057510:Endovascular Procedures / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015607:Stents; D013524:Surgical Flaps; D016896:Treatment Outcome