A rare case of an acute type B aortic dissection contained infrarenal rupture of the false lumen after prior endovascular abdominal aneurysm repair

Elena Streck; Yaser Souri; Alexander Hyhlik-Dürr

doi:10.1016/j.jvscit.2023.101366

A rare case of an acute type B aortic dissection contained infrarenal rupture of the false lumen after prior endovascular abdominal aneurysm repair

J Vasc Surg Cases Innov Tech. 2023 Nov 10;10(1):101366. doi: 10.1016/j.jvscit.2023.101366. eCollection 2024 Feb.

Authors

Elena Streck¹, Yaser Souri¹, Alexander Hyhlik-Dürr¹

Affiliation

¹ Department of Vascular Surgery, Medical Faculty, Augsburg University Hospital, Augsburg, Germany.

Abstract

New-onset acute type B aortic dissection after prior endovascular aneurysm repair is extremely rare. Extension of an aortic dissection can cause destabilization of the previously implanted stent graft, thrombosis of the stent graft, and rupture of the aneurysmal sac, with high mortality without therapy. This report describes the case of a 66-year-old patient complaining of sudden abdominal pain radiating to both flanks. Computed tomography angiography of the aorta revealed acute type B aortic dissection with infrarenal rupture of the false lumen after endovascular abdominal aneurysm repair 5 years prior. The patient underwent infrarenal open surgical conversion with suprarenal aortic clamping and implantation of a bifurcated Dacron graft. Postoperatively, no serious complications resulted from the treatment, except for fascial dehiscence. In such cases, the patients can be treated in an emergency situation with open repair, despite the high risk of complications and mortality.

Keywords: ATBD; Acute type B dissection; Aortic abdominal rupture; Endovascular repair; Open repair.

Publication types

Case Reports