title: Percutaneous stenting of a dissected superior mesenteric artery in a patient with previous surgical repair of Stanford type A aortic dissection.
abstract: OBJECTIVE
  We report a case of a 54-year-old male patient with background history of hypertension, which suffered a Stanford type A thoraco-abdominal aortic dissection with extension to the visceral arteries.
  
  
  METHODS
  The patient initially underwent surgical repair with replacement of the ascending aorta and of the hemiarch in the acute phase of the dissection. Postoperatively, he developed non-specific abdominal pain that was not related to meals but led to weight loss of 20 kg within the first five post-operative months. Follow-up computerized tomography scan revealed a chronic subphrenic aortic dissection extending to the celiac axis (with involvement of the left gastric and the splenic artery), the left renal artery and the superior mesenteric artery (SMA). The hepatic artery took origin from the SMA and received blood from the true lumen of the vessel, and the right renal artery was entirely supplied from the true aortic lumen. After exclusion of other causes of abdominal pain, the patient was treated with percutaneous stent placement in the dissected SMA with significant improvement of his symptoms.
  
  
  CONCLUSIONS
  This case report emphasizes the role of visceral artery endovascular techniques in the management of patients with complicated chronic aortic dissection. Hippokratia 2015; 19 (3): 270-273.
authors.affiliation: Department of Radiology, University Hospital Heraklion, Medical School of Crete, Heraklion, Greece.
authors.forename: A
authors.initials: A
authors.lastname: Hatzidakis
authors.affiliation: Department of Radiology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
authors.forename: M
authors.initials: M
authors.lastname: Krokidis
authors.affiliation: Vascular Surgeon, Heraklion, Greece.
authors.forename: Z
authors.initials: Z
authors.lastname: Androulakakis
authors.affiliation: Interventional Radiology Unit, S. Andrea University Hospital, Rome, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Rossi
keywords: Aortic dissection; endovascular repair; mesenteric stenting