Limited Distal Arch Open Stenting for Type B Aortic Dissection with an Enlarged Ulcer-Like Projection, Complicated by Abdominal Aortic Occlusion

Abstract

A 79-year-old man underwent bifurcated graft replacement for abdominal aortic aneurysm, but the graft was totally occluded owing to an acute type B aortic dissection. We could not have access to the root for performing endovascular stenting for dissecting aneurysm. Furthermore, it was difficult to remove the aneurysm via a left thoracotomy because it was impossible to perfuse the lower body with blood from the femoral artery and also a left axillary arterial cannulation was unusable. Herein, we report a patient who was successfully treated with open surgical aortic stenting for an enlarged ulcer-like projection complicated by a type B aortic dissection.

Keywords

aortic aneurysm - cardiovascular surgery - aortic stent

• References

• 1 Ishida M, Kato N, Hirano T, Cheng SH, Shimono T, Takeda K. Endovascular stent-graft treatment for thoracic aortic aneurysms: short- to midterm results. J Vasc Interv Radiol 2004; 15 (4) 361-367
• 2 Estrera AL, Sandhu H, Afifi RO , et al. Open repair of chronic complicated type B aortic dissection using the open distal technique. Ann Cardiothorac Surg 2014; 3 (4) 375-384
• 3 Brunkwall J, Lammer J, Verhoeven E, Taylor P. ADSORB: a study on the efficacy of endovascular grafting in uncomplicated acute dissection of the descending aorta. Eur J Vasc Endovasc Surg 2012; 44 (1) 31-36
• 4 Hata M, Orime Y, Akiyama K , et al. Outcomes of open surgical repair for type B dissecting aortic aneurysm with alternative methods in the endovascular stent era. Semin Thorac Cardiovasc Surg 2015; 27 (2) 106-112
• 5 Hata M, Akiyama K, Orime Y, Wakui S, Nakamura T, Shiono M. Less invasive quick open stenting using A J Graft Open Stent for distal arch aneurysms. Thorac Cardiovasc Surg 2016; 64 (4) 330-332