title: Surgical Fenestration for Lower Limb Ischemia Developing from Chronic Type B Aortic Dissection: A Report of 2 Cases.
abstract: Lower limb ischemia caused by type B aortic dissection typically presents with a leg-threatening condition in the acute phase. However, in some cases, lower limb ischemia symptom develops as intermittent claudication in the chronic phase. Although surgical fenestration has been used for treating ischemic complications of aortic dissection, it has recently become an alternative option for such cases because of the significant advance of endovascular treatments. We report 2 cases of chronic type B aortic dissection complicated by lower limb ischemia. Two male patients aged 57 and 43 years presented with intermittent claudication more than 2 weeks after the onset of the disease. On the basis of anatomic condition of the dissected aorta, we successfully performed surgical fenestration through a median laparotomy. In the current endovascular era, surgical fenestration remains an effective and durable option for treating lower limb ischemia caused by chronic type B aortic dissection.
authors.affiliation: Department of Cardiovascular Surgery, Tsukuba Medical Center Hospital, Tsukuba, Japan. Electronic address: ai-cvs@sd6.so-net.ne.jp.
authors.forename: Akihiko
authors.initials: A
authors.lastname: Ikeda
authors.affiliation: Department of Cardiovascular Surgery, Tsukuba Medical Center Hospital, Tsukuba, Japan.
authors.forename: Yohei
authors.initials: Y
authors.lastname: Kudo
authors.affiliation: Department of Cardiovascular Surgery, Tsukuba Medical Center Hospital, Tsukuba, Japan.
authors.forename: Taisuke
authors.initials: T
authors.lastname: Konishi
authors.affiliation: Department of Cardiovascular Surgery, Tsukuba Medical Center Hospital, Tsukuba, Japan.
authors.forename: Kanji
authors.initials: K
authors.lastname: Matsuzaki
authors.affiliation: Department of Cardiovascular Surgery, Tsukuba Medical Center Hospital, Tsukuba, Japan.
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Jikuya
mesh_terms: D000328:Adult; D000784:Aortic Dissection / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D017544:Aortic Aneurysm, Abdominal / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D001027:Aortography / Q000379:methods; D002908:Chronic Disease; D006801:Humans; D007383:Intermittent Claudication / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D007511:Ischemia / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D035002:Lower Extremity / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed