Abstract
Purpose: To present a rare case of thoracoabdominal aortic dissecting aneurysm combined with aneurysm related disseminated intravascular coagulation (DIC) and the novel treatment of total endovascular aneurysm repair (EVAR) with Sandwich technique. Case Report: A 78-year-old man was admitted with thoracoabdominal aortic dissecting aneurysm (TAADA) combined with bilateral iliac artery aneurysm (BIAA) accompanied by aneurysm related DIC. With adequate transfusion of blood components and a continuous subcutaneous injection of low molecular weight heparin, surgical repair of the multiple aortic lesions was carried out successfully. He received a total endovascular repair by sandwich technique to reconstruct all visceral branches. Postoperative laboratory evaluation demonstrated resolution of the coagulopathy. The optimal quality of life were achieved without any coagulopathy, paraplegia, pelvic organs ischemia or claudication and with an ideal blood pressure control during the 2-years’ following-up. Conclusion: Total endovascular aneurysm repair by sandwich technique appears to be a feasible, safe, and effective treatment for the management of thoracoabdominal aortic dissecting aneurysm. Confidential conclusion needs more cases to be done.
Highlights
Since Parodi first reported the endovascular aneurysm repair (EVAR) in the management of abdominal aortic aneurysm (AAA) in 1991 [1], endovascular treatment has become the predominant method for Standford B dissection or infrarenal abdominal aneurysm [2]
We reported a rarely complicated case presenting with multiple aortic lesions including thoracoabdominal aortic dissecting aneurysm (TAADA) and bilateral iliac artery aneurysm (BIAA) accompanied by aneurysm related disseminated intravascular coagulation (DIC) in a 76-year-old male
Superior mesenteric artery (SMA), celiac trunk and left renal artery (LRA) emerged from the true lumen and right renal artery stemmed from false lumen (Figure 1)
Summary
Since Parodi first reported the endovascular aneurysm repair (EVAR) in the management of abdominal aortic aneurysm (AAA) in 1991 [1], endovascular treatment has become the predominant method for Standford B dissection or infrarenal abdominal aneurysm [2]. We reported a rarely complicated case presenting with multiple aortic lesions including thoracoabdominal aortic dissecting aneurysm (TAADA) and bilateral iliac artery aneurysm (BIAA) accompanied by aneurysm related disseminated intravascular coagulation (DIC) in a 76-year-old male. Blood test indicated DIC with prothrombin time (PT), 14.3s; activated partial thromboplastin time (APTT), 43.2s; prothrombin time international normalized ratio (INR), 1.25; platelet count (PLT), 89*109/L; fibrinogen (Fbg), 0.72 g/L; fibrinogen degradation products (FDP), 154.7 mg/L; D-Dimer 51.37 mg/L. He had a history of hypertension, coronary atherosclerotic heart disease, chronic renal dysfunction and smoking. © Copyright iMedPub | This article is available from: http://vascular-endovascular-surgery.imedpub.com/archive.php
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
