Acute type B aortic dissection extending into arteria lusoria - unexpected challenge of endovascular treatment with chimney technique: case report

2020 ◽  
Author(s):  
Gloria Adam ◽  
Ivo Petrov ◽  
Zoran Stankov ◽  
Metodi Mihailov
Keyword(s):  
Case Report ◽  
Aortic Dissection ◽  
Endovascular Treatment ◽  
Acute Type ◽  
Type B ◽  
Type B Aortic Dissection ◽  
Chimney Technique ◽  
Arteria Lusoria

scholarly journals Five-Year Results of STABLE II Study for Endovascular Treatment of Complicated, Acute Type B Aortic Dissection With a Composite Device Design

2021 ◽  
Vol 74 (3) ◽  
pp. e89
Author(s):  
Joseph V. Lombardi ◽  
Thomas Gleason ◽  
Jean M. Panneton ◽  
Ben Starnes ◽  
Michael D. Dake ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Endovascular Treatment ◽  
Acute Type ◽  
Type B ◽  
Device Design ◽  
Type B Aortic Dissection

Don't get in a flap!: A case report of progression through the spectrum of an acute aortic syndrome

Vascular ◽  
2014 ◽  
Vol 22 (6) ◽  
pp. 454-457 ◽  
Author(s):  
Andrew MTL Choong ◽  
Saroj Das ◽  
Nicholas Mulrenan ◽  
Mohamad Hamady ◽  
Protip Bose
Keyword(s):  
Case Report ◽  
Chest Pain ◽  
Aortic Dissection ◽  
Vascular Surgery ◽  
Acute Type ◽  
Medical Team ◽  
Acute Aortic Syndrome ◽  
Type B ◽  
Type B Aortic Dissection ◽  
Acute Aortic Syndromes

Purpose To present a single case that clearly demonstrates the progression through the whole spectrum of an acute aortic syndrome, from a solitary penetrating aortic ulcer (PAU) through to multiple PAUs with intra-mural haematoma (IMH) progression. The index images show that despite the clinical presentation of an acute type B aortic dissection, a classical dissection flap is never demonstrated in this patient and thus highlights the need for early input from vascular surgery for all potential acute aortic syndromes. Case report We present the case of a 71-year-old lady who attended the emergency department with hypertension and inter-scapular chest pain. Upon investigation with computed tomography aortography (CTA), she was found to have a solitary PAU only with minimal IMH. She did not demonstrate any classical radiological signs of acute type B aortic dissection. She was admitted under a medical team and her chest pain abated with no treatment. The treating medical team adjusted her anti-hypertensive medication and discharged her home with an urgent vascular surgical outpatient appointment for further follow-up and surveillance. We acknowledge that a preferred approach would have been, at least admission and close blood pressure monitoring, with a repeat CTA the next day. Two days later, she represented with further chest pain and on repeat CTA was found to have multiple PAUs and progression of the small IMH. She was then admitted under vascular surgery and subsequently transferred to the parent tertiary referral vascular surgical unit. Despite aggressive anti-hypertensive management, she had persistent intractable chest pain and was treated with a single thoracic stent graft. Completion angiography demonstrated total resolution of the PAUs. Conclusion This case along with index images demonstrates the whole spectrum of the acute aortic syndrome from a solitary PAU to multiple PAUs with IMH extension. Despite an eventual clinical picture of an acute type B aortic dissection, there was a notable absence of a classical dissection flap on any imaging. We recommend that all aortic pathologies should be at least discussed with and preferably managed by vascular surgeons. The absence of a classical dissection flap on imaging is not a contra-indication to emergent treatment with thoracic stent grafting and in select patients is actually the only therapy that will treat this pathology.

Endovascular treatment of acute type B aortic dissection

2004 ◽  
Vol 104 (5) ◽  
pp. 513-518 ◽  
Author(s):  
P. R. Taylor ◽  
R.E. Bell ◽  
J. F. Reidy
Keyword(s):  
Aortic Dissection ◽  
Endovascular Treatment ◽  
Acute Type ◽  
Type B ◽  
Type B Aortic Dissection

Severe Acute Type B Aortic Dissection Complicated by Acute Pancreatitis: A Case Report

2018 ◽  
Vol 47 ◽  
pp. 279.e19-279.e24 ◽  
Author(s):  
Jin Jie ◽  
Wu Yongfa ◽  
Wang Yuxin ◽  
Liao Mingfang ◽  
Qu Lefeng
Keyword(s):  
Acute Pancreatitis ◽  
Case Report ◽  
Aortic Dissection ◽  
Acute Type ◽  
Type B ◽  
Type B Aortic Dissection

scholarly journals Arc of Buhler: A lifesaving anatomic variation. A case report

2020 ◽  
Vol 19 ◽  
Author(s):  
Schizas Nikolaos ◽  
Patris Vasilios ◽  
Lama Niki ◽  
Eleftherios Orestis Argyriou ◽  
Kratimenos Theodoros ◽  
...  
Keyword(s):  
Case Report ◽  
Aortic Dissection ◽  
Blood Supply ◽  
Anatomic Variation ◽  
Anatomical Variation ◽  
Celiac Artery ◽  
Acute Type ◽  
Type B ◽  
Type B Aortic Dissection ◽  
Type B Dissection

Abstract The presence of malperfusion syndrome in cases of complicated acute type B aortic dissection is a negative predictive factor and urgent intervention is indicated. Anatomic variations, such as the Arc of Buhler, contribute anastomotic channels and can preserve the visceral blood supply. In this case report, we describe the overall management of a 54-year-old man who presented with a type B aortic dissection. Initially, conservative management was chosen, as indicated for an uncomplicated type B dissection, but the dissection deteriorated. Despite the fact that severe occlusion of the celiac artery was detected on Computed Tomography (CT) angiography, the Arc of Buhler anatomical variation was present, contributing adequate visceral blood supply. After considering this finding, the patient was treated effectively with thoracic endovascular aortic repair (TEVAR).

Sign in / Sign up

Export Citation Format

Share Document