title: [Distal Aortic Arch Aneurysm, Acute type B Aortic Dissection, and Acute Bilateral Limb Ischemia Treated by Two-stage Total Arch Replacement;Report of a Case].
abstract: A 74-year-old female patient experienced sudden and severe pain in her lower back and both legs. Upon examination, her femoral pulses were weak, and her legs were pale. Computed tomography revealed a 66-mm thoracic aneurysm in the distal arch and type B aortic dissection. Stenosis was present from the terminal aorta to the iliac arteries. The left common iliac artery was occluded at its bifurcation, and both lower limbs were ischemic. We performed bilateral axillary-femoral artery bypass, which improved blood flow to both limbs. The next day, it was apparent that compartment syndrome had developed in the patient's left leg. Rehabilitation therapy was effective for the compartment syndrome, the patient's symptoms resolved, and she was discharged. We later performed two-stage total arch replacement, and the subsequent clinical course has been without incident.
authors.affiliation: Department of Cardiovascular Surgery, Jichi Medical University Saitama Medical Center, Saitama, Japan.
authors.forename: Kazunori
authors.initials: K
authors.lastname: Hashimoto
authors.forename: Satoshi
authors.initials: S
authors.lastname: Itoh
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Tajima
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Kimura
authors.forename: Kohichi
authors.initials: K
authors.lastname: Yuri
authors.forename: Harunobu
authors.initials: H
authors.lastname: Matumoto
authors.forename: Kohichi
authors.initials: K
authors.lastname: Adachi
authors.forename: Atushi
authors.initials: A
authors.lastname: Yamaguchi
authors.forename: Hideo
authors.initials: H
authors.lastname: Adachi
mesh_terms: D000368:Aged; D000784:Aortic Dissection / Q000150:complications / Q000601:surgery*; D001013:Aorta, Thoracic / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000150:complications / Q000601:surgery*; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D007511:Ischemia / Q000209:etiology*; D007866:Leg / Q000098:blood supply*; D014057:Tomography, X-Ray Computed