Percutaneous balloon fenestration and stent placement for lower limb ischemia complicated with type B aortic dissection

2006 ◽  
Vol 24 (3) ◽  
pp. 233-237 ◽  
Author(s):  
Masato Yamaguchi ◽  
Koji Sugimoto ◽  
Yoshihiko Tsuji ◽  
Nobuchika Ozaki ◽  
Masakatsu Tsurusaki ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Stent Placement ◽  
Lower Limb ◽  
Limb Ischemia ◽  
Type B ◽  
Type B Aortic Dissection ◽  
Lower Limb Ischemia ◽  
Percutaneous Balloon

Surgical Fenestration for Lower Limb Ischemia Developing from Chronic Type B Aortic Dissection: A Report of 2 Cases

2016 ◽  
Vol 31 ◽  
pp. 208.e9-208.e14 ◽  
Author(s):  
Akihiko Ikeda ◽  
Yohei Kudo ◽  
Taisuke Konishi ◽  
Kanji Matsuzaki ◽  
Tomoaki Jikuya
Keyword(s):  
Aortic Dissection ◽  
Lower Limb ◽  
Limb Ischemia ◽  
Type B ◽  
Type B Aortic Dissection ◽  
Chronic Type ◽  
Lower Limb Ischemia

Role of the femorofemoral crossover graft in acute lower limb ischemia due to acute type B aortic dissection

Vascular ◽  
2013 ◽  
Vol 22 (2) ◽  
pp. 121-126 ◽  
Author(s):  
Lorraine Corfield ◽  
David J McCormack ◽  
Rachel Bell ◽  
Peter Taylor ◽  
John Reidy
Keyword(s):  
Aortic Dissection ◽  
Lower Limb ◽  
Limb Ischemia ◽  
Acute Limb Ischemia ◽  
Acute Type ◽  
Type B ◽  
Type B Aortic Dissection ◽  
Lower Limb Ischemia ◽  
Thoracic Stent Graft

Acute limb ischemia due to type B aortic dissection is rare and continues to be a management challenge. A case series is presented here with the aim of assessing the outcomes of treatment with a femorofemoral crossover graft with or without thoracic stent graft insertion. This is a combined retrospective and prospective review of nine cases of acute lower limb ischemia secondary to acute type B aortic dissection. The presenting features, radiological findings, treatment and outcomes were reviewed. Five patients had a femorofemoral crossover graft (FFXO) alone, two an FFXO with a thoracic stent graft and the eighth a thoracic and iliac stent. The other case was initially treated conservatively but subsequently required an FFXO. The mean follow-up was 16 (3–51) months. A further two thoracic stents were placed during the follow-up period. Thus five out of nine patients (56%) required aortic stenting. This series suggests that an FFXO is a reliable treatment for acute limb ischemia due to type B aortic dissection. However, these patients are often complex with ischemia in other vascular beds and are at risk of subsequent aneurysmal dilation.

Abstract 20003: A 15-year Analysis and Descriptive Study of the Incidence, Clinical Characteristics, Management, and Outcomes of Lower Limb Ischemia in Type A and Type B Aortic Dissection Patients: Insights From the International Registry of Acute Aortic Dissection

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Susan Alaei ◽  
Thoralf M Sundt ◽  
Udo Sechtem ◽  
Truls Myrmel ◽  
Marco Di Eusanio ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Lower Limb ◽  
Acute Aortic Dissection ◽  
Limb Ischemia ◽  
Type A ◽  
Leg Pain ◽  
Type B ◽  
Lower Limb Ischemia ◽  
Over Time ◽  
Overall Mortality

Background: This study assessed the incidence of lower limb ischemia as well as trends in management and outcomes while examining acute aortic dissection patients over a period of 15 years. Additionally, differences in clinical presentation, interventions performed, and mortality between patients with and without lower limb ischemia were investigated. Methods: Lower limb ischemia (LLI) was evaluated among 3812 patients enrolled in the International Registry of Acute Aortic Dissection over a 15-year period that was separated into three 5-year intervals: 1996-2001, 2002-2007, and 2008-2012. The cohort was then divided by dissection type and presence or absence of LLI. Results: Type A patients presenting with limb ischemia (N=280, 11.4%) were much more likely to have atherosclerosis (p=0.021) and to present with back, abdominal and leg pain versus chest pain (p<0.001 unless noted). Other symptoms of malperfusion, including ischemic spinal cord damage (p<0.001) and coma/altered consciousness (p=0.006) were more common in patients presenting with LLI. Surgery was less commonly performed in Type A LLI patients (79.3% vs 86.1%, p=0.002), a difference that did not change over time (p=0.453, trend p=0.479). Additionally, overall mortality was higher in LLI patients (37.5% vs 22.9%, p<0.001) and did not show improvement among the LLI cohort over time. Type B patients with LLI (N=102, 7.5%) were more likely to be current smokers (p=0.028), to present febrile (p=0.022), and to have leg pain (p<0.001). As with Type A, ischemic spinal cord damage was more common in the LLI cohort (p<0.001). Patients with LLI were much more likely to be managed with endovascular therapy (19.6% vs 50.0%, p<0.001) than with medication alone (66.5% vs 29.4%, p<0.001), with endovascular repair increasing in LLI patients over time (p=0.008, trend p=0.002). Again, overall mortality was higher in the LLI cohort (24.5% vs 9.7%, p<0.001) and did not change over time. Conclusions: Although Type B patients with LLI received more endovascular procedures in later years, overall mortality did not improve. Increased complications and higher mortality in the LLI cohort suggests a need for better monitoring and increased implementation of interventions in this population.

scholarly journals Surgical Fenestration for Acute Type A Aortic Dissection with Visceral and Lower Limb Ischemia and Paraplegia

2021 ◽  
Vol 50 (6) ◽  
pp. 405-409
Author(s):  
Kiyotaka Suzuki ◽  
Keiji Uchida ◽  
Tomoyuki Minami ◽  
Tomoki Cho ◽  
Yusuke Matsuki ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Lower Limb ◽  
Limb Ischemia ◽  
Type A ◽  
Acute Type ◽  
Type A Aortic Dissection ◽  
Lower Limb Ischemia

Type A acute aortic dissection complicated by lower limb ischemia

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Andrea Daprati ◽  
Andrea Garatti ◽  
Alberto Canziani ◽  
Alessandro Parolari
Keyword(s):  
Aortic Dissection ◽  
Lower Limb ◽  
Acute Aortic Dissection ◽  
Limb Ischemia ◽  
Type A ◽  
Lower Limb Ischemia

Renal Artery Stent Placement Complicated by Development of a Type B Aortic Dissection

2004 ◽  
Vol 28 (1) ◽  
pp. 98-101 ◽  
Author(s):  
Scott W. Haesemeyer ◽  
Suresh Vedantham ◽  
Alan Braverman
Keyword(s):  
Aortic Dissection ◽  
Renal Artery ◽  
Stent Placement ◽  
Type B ◽  
Type B Aortic Dissection ◽  
Renal Artery Stent
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