Abstract
Secondary dissection in the descending aorta after endovascular therapy may demand subsequent interventional procedures. This can set a particularly significant challenge for the endovascular specialist. When implanting an aortic prosthesis, a sufficient contact between the covered segment and the healthy vessel wall is advisable. However, our case shows that, in individual cases, it is indeed efficient to place an aortic stent graft on top of the distal end of the dissection. This is proven by a three-year follow-up CT-angiography.
Highlights
The management of dissections of the thoracoabdominal aorta with a marginal distal landing zone remains controversial
Despite the blood pressure had been normalized due to adapted antihypertensive medication, the whole aortic lumen diameter at the dissection site proximal to the celiac trunk increased by 1 cm
First described by Krukenberg in 1920, it was initially seen as hemorrhage of the aortic vasa vasorum [1]
Summary
The management of dissections of the thoracoabdominal aorta with a marginal distal landing zone remains controversial. Surgical reconstruction provides a safe way to avoid the risk of visceral branch occlusion. Endovascular therapy should be considered when a scarce distal landing is possible. We report a case in which a thoracic aortic stent graft was distally extended in order to successfully treat a secondary dissection close to the celiac trunk’s origin
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