Simultaneous endovascular treatment of synchronous symptomatic acute type B aortic dissection and large infrarenal aortic aneurysm. Technical tips and case report

Ettore Dinoto; Felice Pecoraro; Arduino Farina; Alessia Viscardi; Guido Bajardi

doi:10.1016/j.ijscr.2020.07.060

Simultaneous endovascular treatment of synchronous symptomatic acute type B aortic dissection and large infrarenal aortic aneurysm. Technical tips and case report

Int J Surg Case Rep. 2020;77S(Suppl):S157-S161. doi: 10.1016/j.ijscr.2020.07.060. Epub 2020 Aug 11.

Authors

Ettore Dinoto¹, Felice Pecoraro², Arduino Farina³, Alessia Viscardi⁴, Guido Bajardi²

Affiliations

¹ Vascular Surgery Unit, AOUP Policlinico 'P. Giaccone', Palermo, Italy. Electronic address: ettore.dinoto@policlinico.pa.it.
² Vascular Surgery Unit, AOUP Policlinico 'P. Giaccone', Palermo, Italy; Department of Surgical, Oncological and Oral Sciences, University of Palermo, Italy.
³ Vascular Surgery Unit, AOUP Policlinico 'P. Giaccone', Palermo, Italy.
⁴ Department of Public Health, Vascular Surgery Unit, University Federico II of Naples, Naples, Italy.

Abstract

Introduction: Data from the literature suggest that in patients with acute type B aortic dissection (ATBAD), associated with AAA, rupture risk is higher at the confluence tract than isolated lessions. Herein, we report a case of ATBAD and AAA managed with simultaneous intervention.

Case presentation: We report a complicated case of a symptomatic patient presenting with a type B aortic dissection and false lumen extension into superior mesenteric artery (SMA) with an infrarenal abdominal aortic aneurysm (AAA). Severe back pain and hypertension were the patient's initial complaints. This patient underwent endovascular repair with a thoracic and infrarenal aortic endograft.

Discussion: AAA rupture has been detected at admission in three-fourths of patients with ATBAD that extended to or involved a coexisting unoperated atherosclerotic aneurysms. Prompt surgical intervention is essential to deal with this dreadful aortic emergency.

Conclusion: In our experience a totally endovascular solution to treat a complicated ATBAD plus AAA was a rapid solution with low invasivity, no complication and complete healing of patients.

Keywords: Case report; Complicated aortic B dissection; PETTICOAT.

Publication types

Case Reports