Abstract
Thoracic endovascular aortic repair for aortic dissections is recognized as an effective treatment. We herein report the case of a 72-year-old male with a Stanford type B aortic dissection. A stent-graft and double-disk vascular occluder was used to repair the primary and re-entry tears, respectively. At 3 month postoperatively, computed tomographic angiography revealed no endoleaks, the stent-graft and vascular occluder to be in optimal positions, the false lumen was almost completely thrombosed, and the visceral arteries were patent. This case illustrates that it is feasible to treat re-entry tears with a vascular occluder after primary proximal stent-graft repairs.
Highlights
Aortic dissection is the most common acute emergency involving the aorta, and often results in death
The efficacy and safety of thoracic endovascular aortic repair (TEVAR) for acute [5,6,7] and chronic [8,9,10] aortic dissections has been shown in a many studies
Computed tomography revealed an aortic dissection with entry and re-entry tears (Figure 1)
Summary
Aortic dissection is the most common acute emergency involving the aorta, and often results in death. We report a case in which we applied a stent-graft and double-disk vascular occluder to repair the primary and re-entry tears, respectively, in a patient with Stanford type B aortic dissection. Computed tomography revealed an aortic dissection with entry and re-entry tears (Figure 1). Angiography demonstrated a Stanford type B aortic dissection with the primary tear distal to the left subclavian artery, and a re-entry tear below the superior mesenteric artery orifice (Figure 2A). The anterior disk (26 mm) was deployed in the false lumen against the dissection flap after passing through the rupture, and the waist of the occluder was placed in the re-entry tear, which was both felt and observed by fluoroscopy. The stent-graft and vascular occluder were in optimal positions, and the visceral arteries (except the right renal artery) were patent
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