Fenestration of the intima to facilitate successful endovascular repair of a dissecting abdominal aneurysm

Abstract

Aortic aneurysm is an enlargement of the aorta with a loss of the arterial wall parallelism. There are several possible causes concerning etiology, one of which is the postsurgical presence of a patent distal false lumen. An aortic aneurysm is mainly seen after a surgery for type A aortic dissection and it represents an important late complication. Even more, in some cases the abdominal aortic aneurysm could be complicated by a patent distal false lumen, which makes it challenging for further treatment. We present a case of a 44-year-old male patient with Marfan syndrome and the history of a surgical repair of type A aortic dissection. He was diagnosed with a large abdominal aortic aneurysm and patent distal false lumen. In this report, we describe our technique and the outcome for endovascular fenestration of the persistent intimal flap and the stent-graft implantation for abdominal aortic aneurysm isolation after the surgery for aortic dissection type A. Our technique presents a novelty approach to patients with abdominal aortic aneurysm, complicated with a patent distal false lumen.

Keywords: Aortic aneurysm; Fenestration; Patent distal false lumen.