title: Treatment with Aortic Stent Graft Placement for Stanford B-Type Aortic Dissection in a Patient with an Aberrant Right Subclavian Artery.
abstract: A 71-year-old man visited our hospital with the chief complaint of back pain and was diagnosed with acute aortic dissection (Debakey type III, Stanford type B). He was found to have a variant branching pattern in which the right subclavian artery was the fourth branch of the aorta. We performed conservative management for uncomplicated Stanford type B aortic dissection, and the patient was discharged. An ulcer-like projection (ULP) was discovered during outpatient follow-up. Complicated type B aortic dissection was suspected, and we performed thoracic endovascular aortic repair (TEVAR). The aim of operative treatment was ULP closure; thus we placed two stent grafts in the descending aorta from the distal portion of the right subclavian artery. The patient was released without complications on postoperative day 5. Deliberate sizing and examination of placement location were necessary when placing the stent graft, but operative techniques allowed the procedure to be safely completed.
authors.affiliation: Department of Cardiovascular Surgery, Chiba-Nishi General Hospital, 107-1 Kanegasaku, Matsudo-Shi, Chiba-ken 2702251, Japan.
authors.forename: Yohei
authors.initials: Y
authors.lastname: Kawatani
authors.affiliation: Department of Cardiovascular Surgery, Chiba-Nishi General Hospital, 107-1 Kanegasaku, Matsudo-Shi, Chiba-ken 2702251, Japan.
authors.forename: Yujiro
authors.initials: Y
authors.lastname: Hayashi
authors.affiliation: Department of Cardiovascular Surgery, Chiba-Nishi General Hospital, 107-1 Kanegasaku, Matsudo-Shi, Chiba-ken 2702251, Japan.
authors.forename: Yujiro
authors.initials: Y
authors.lastname: Ito
authors.affiliation: Department of Cardiovascular Surgery, Chiba-Nishi General Hospital, 107-1 Kanegasaku, Matsudo-Shi, Chiba-ken 2702251, Japan.
authors.forename: Hirotsugu
authors.initials: H
authors.lastname: Kurobe
authors.affiliation: Department of Cardiovascular Surgery, Chiba-Nishi General Hospital, 107-1 Kanegasaku, Matsudo-Shi, Chiba-ken 2702251, Japan.
authors.forename: Yoshitsugu
authors.initials: Y
authors.lastname: Nakamura
authors.affiliation: Department of Cardiovascular Surgery, Chiba-Nishi General Hospital, 107-1 Kanegasaku, Matsudo-Shi, Chiba-ken 2702251, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Suda
authors.affiliation: Department of Cardiovascular Surgery, Chiba-Nishi General Hospital, 107-1 Kanegasaku, Matsudo-Shi, Chiba-ken 2702251, Japan.
authors.forename: Takaki
authors.initials: T
authors.lastname: Hori