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Emergency thoracic aortic stent grafting for acute complicated type B aortic dissection after a previous abdominal endovascular aneurysm repair.

Yoshiga R, Morisaki K, Matsubara Y, Yoshiya K, Inoue K, Matsuda D, Aoyagi Y, Tanaka S, Okadome J, Matsumoto T, Maehara Y - Surg Case Rep (2015)

Bottom Line: Emergency thoracic endovascular repair (TEVAR) was performed to close the entry tear.After the operation, the image views and the symptoms were improved.The state was still stable 6 months later.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University Maidashi3-1-1, Higashi-ku, Fukuoka, 812-8582, Fukuoka, Japan.

ABSTRACT
We report a case of acute type B aortic dissection with the complication of bowel ischemia and abdominal stent graft compression treated by emergency thoracic aortic stent grafting after endovascular aneurysm repair (EVAR) for abdominal aortic aneurysm (AAA). A 69-year-old male was admitted to our hospital for sudden thoraco-abdominal pain. He had past treatment history of EVAR for AAA half a year ago. A computed tomography (CT) showed acute type B aortic dissection, and conservative treatment was initially performed. Three days after occurrence of aortic dissection, worsened abdominal pain and melena were observed. CT showed that the true lumen and abdominal stent graft was compressed by the false lumen. Emergency thoracic endovascular repair (TEVAR) was performed to close the entry tear. After the operation, the image views and the symptoms were improved. The state was still stable 6 months later. TEVAR for acute type B aortic dissection can become one of the effective treatments.

No MeSH data available.


Related in: MedlinePlus

Postoperative CT images of aorta at 6 months later. Compressions of the true lumen and the abdominal stent graft are improved. The false lumen is partially thrombosed without any dilatation of the false lumen. “F” indicates false lumen. “T” indicates true lumen. a CT image of thoracic aorta. b CT image of abdominal aorta. c CT image at the level of the celiac artery. d CT image at the level of the expanded previously abdominal stent graft (ENDURANT). Superior mesenteric artery (SMA) is shown with good contrast effects suggesting improved the blood flow of SMA
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Fig2: Postoperative CT images of aorta at 6 months later. Compressions of the true lumen and the abdominal stent graft are improved. The false lumen is partially thrombosed without any dilatation of the false lumen. “F” indicates false lumen. “T” indicates true lumen. a CT image of thoracic aorta. b CT image of abdominal aorta. c CT image at the level of the celiac artery. d CT image at the level of the expanded previously abdominal stent graft (ENDURANT). Superior mesenteric artery (SMA) is shown with good contrast effects suggesting improved the blood flow of SMA

Mentions: The abdominal pain and ischemia of the left leg were improved following the emergency operation. Postoperative CT at 6 months later showed the false lumen was partially thrombosed without any dilatation of the false lumen (Fig. 2).Fig. 2


Emergency thoracic aortic stent grafting for acute complicated type B aortic dissection after a previous abdominal endovascular aneurysm repair.

Yoshiga R, Morisaki K, Matsubara Y, Yoshiya K, Inoue K, Matsuda D, Aoyagi Y, Tanaka S, Okadome J, Matsumoto T, Maehara Y - Surg Case Rep (2015)

Postoperative CT images of aorta at 6 months later. Compressions of the true lumen and the abdominal stent graft are improved. The false lumen is partially thrombosed without any dilatation of the false lumen. “F” indicates false lumen. “T” indicates true lumen. a CT image of thoracic aorta. b CT image of abdominal aorta. c CT image at the level of the celiac artery. d CT image at the level of the expanded previously abdominal stent graft (ENDURANT). Superior mesenteric artery (SMA) is shown with good contrast effects suggesting improved the blood flow of SMA
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4596147&req=5

Fig2: Postoperative CT images of aorta at 6 months later. Compressions of the true lumen and the abdominal stent graft are improved. The false lumen is partially thrombosed without any dilatation of the false lumen. “F” indicates false lumen. “T” indicates true lumen. a CT image of thoracic aorta. b CT image of abdominal aorta. c CT image at the level of the celiac artery. d CT image at the level of the expanded previously abdominal stent graft (ENDURANT). Superior mesenteric artery (SMA) is shown with good contrast effects suggesting improved the blood flow of SMA
Mentions: The abdominal pain and ischemia of the left leg were improved following the emergency operation. Postoperative CT at 6 months later showed the false lumen was partially thrombosed without any dilatation of the false lumen (Fig. 2).Fig. 2

Bottom Line: Emergency thoracic endovascular repair (TEVAR) was performed to close the entry tear.After the operation, the image views and the symptoms were improved.The state was still stable 6 months later.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University Maidashi3-1-1, Higashi-ku, Fukuoka, 812-8582, Fukuoka, Japan.

ABSTRACT
We report a case of acute type B aortic dissection with the complication of bowel ischemia and abdominal stent graft compression treated by emergency thoracic aortic stent grafting after endovascular aneurysm repair (EVAR) for abdominal aortic aneurysm (AAA). A 69-year-old male was admitted to our hospital for sudden thoraco-abdominal pain. He had past treatment history of EVAR for AAA half a year ago. A computed tomography (CT) showed acute type B aortic dissection, and conservative treatment was initially performed. Three days after occurrence of aortic dissection, worsened abdominal pain and melena were observed. CT showed that the true lumen and abdominal stent graft was compressed by the false lumen. Emergency thoracic endovascular repair (TEVAR) was performed to close the entry tear. After the operation, the image views and the symptoms were improved. The state was still stable 6 months later. TEVAR for acute type B aortic dissection can become one of the effective treatments.

No MeSH data available.


Related in: MedlinePlus