Chronic Chest Pain After Uncomplicated Type B Aortic Dissection: An Unusual Application of Embolotherapy

2021 ◽  
Author(s):  
Austin J. Pourmoussa ◽  
Ashwin Mahendra ◽  
Ripal T. Gandhi ◽  
Barry T. Katzen
Keyword(s):  
Chest Pain ◽  
Aortic Dissection ◽  
Type B ◽  
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.

Is occluding the reentry an endovascular option for treatment of Stanford type B aortic dissection?

2009 ◽  
Vol 56 (S 01) ◽  
Author(s):  
B Rylski ◽  
M Siepe ◽  
M Südkamp ◽  
C Schlensak ◽  
F Beyersdorf ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Type B ◽  
Type B Aortic Dissection ◽  
Stanford Type B

Surgical treatment of acute type B aortic dissection associated with use of cocaine

2009 ◽  
Vol 150 (3) ◽  
pp. 129-131 ◽  
Author(s):  
Zoltán Szeberin ◽  
Gábor Firneisz ◽  
Gábor Bíró ◽  
Gábor Viktor Szabó ◽  
Péter Sótonyi ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Aortic Dissection ◽  
Acute Type ◽  
Type B ◽  
Type B Aortic Dissection

A kokainfogyasztás gyakorisága Magyarországon is növekszik. E drog használata fokozott kockázatot jelent szív- és érrendszeri betegségek kialakulása, például aortadissectio szempontjából. Klinikánkon zajlik hazánkban a B típusú aortadissectiós betegek döntő többségének ellátása. Célkitűzés: Egy rendszeresen kokaint használó, akut B típusú aortadissectiót elszenvedett beteg műtéti kezelését mutatjuk be esetismertetésünkben, amely tudomásunk szerint az első hasonló eset hazánkban. Módszer: Esetleírás. Eredmények: Egy 35 éves férfi erős, mellkasi-háti-deréktáji fájdalmak miatt először a gerincsebészeti osztályhoz fordult, majd kiugróan magas vérnyomásértékek miatt belgyógyászati osztályra helyezték át. A B típusú aortadissectio diagnózisát CT-angiographia igazolta, a beteg érsebészeti centrumba került, ahol sikeres műtétet, thoracoabdominalis aortarefenesztrációt végeztünk. A beteg 3 hónappal a műtét után jól van, antihipertenzív szerek szedése mellett mindennapi feladatait ellátja, szövődményt nem észleltünk, a kokainról leszokott. Következtetések: Az akut B típusú dissectio sebészi ellátása megmentheti a beteg életét. A hosszú távú eredményes kezelésben a hipertónia kontrollja mellett a kokainról történő leszokás alapvető jelentőségű. Hasonló esetek előfordulására a kokainfogyasztás növekedése esetén hazánkban is számíthatunk.

Complications After Endovascular Repair of Type B Aortic Dissection

2002 ◽  
Vol 9 (6) ◽  
pp. 822-828 ◽  
Author(s):  
Reinhard S. Pamler ◽  
Thomas Kotsis ◽  
Johannes Görich ◽  
Xaver Kapfer ◽  
Karl-Heinz Orend ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Endovascular Repair ◽  
Type B ◽  
Type B Aortic Dissection

Endovascular Repair of a Type B Aortic Dissection With Transposition of a Coexistent Aberrant Subclavian (Lusorian) Artery

2002 ◽  
Vol 9 (4) ◽  
pp. 549-553 ◽  
Author(s):  
A. W. Floris Vos ◽  
Willem Wisselink ◽  
Abraham Rijbroek ◽  
Jurgen A. Avontuur ◽  
Radu A. Manoliu ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Endovascular Repair ◽  
Type B ◽  
Type B Aortic Dissection ◽  
Lusorian Artery
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