De novo acute type B aortic dissection in two patients with previous infrarenal endovascular aortic aneurysm repair with EndoAnchors

Abstract

<h2>Abstract</h2> Acute aortic dissections in the immediate postoperative period following endovascular abdominal aortic aneurysm repair (EVAR) have been linked to technical factors such as excessive endograft oversizing or aortic wall injuries during the procedure, whereas dissections that occur later are more likely to be de novo. Regardless of their etiology, aortic dissections can extend in the abdominal aorta, causing collapsing and occlusion of the endograft with devastating complications. There have been no reports of aortic dissections in EVAR patients in whom endoanchors were used. We present two cases of de novo type B aortic dissection (TBAD) after EVAR with entry tears in the descending thoracic aorta. Interestingly in both of our cases the dissection flap appeared to stop abruptly at the site of endograft fixation with the endo-anchors, suggesting that end-anchors might prevent propagation of aortic dissections beyond the endoanchor fixation level and thus protect the EVAR from collapsing.