scholarly journals Chronic abdominal aortic dissection, endovascular treatment using a new Stent-graft for in situ Fenestration

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Hernan G. Bertoni ◽  
German A. Girela ◽  
Hector D. Barone ◽  
Federico De Caso ◽  
Alejandro De La Vega ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Endovascular Treatment ◽  
Stent Graft ◽  
Covered Stent ◽  
Left Renal Artery ◽  
Abdominal Aortic ◽  
History Of ◽  
Elective Procedure ◽  
Abdominal Aortic Dissection

Abstract Background Although endovascular treatment of the thoracic aorta (TEVAR) has become an elective procedure for treatment of complicated type B aortic dissection, its role in treating post dissection thoraco-abdominal aortic aneurysm (TAAA), is still limited. This is a case of aortic vascular disease, which reports the use of a new endovascular device. Case presentation : We present the case of a 62 year old male patient with a history of hypertension, active smoker, who presented penetrating descending thoracic aortic ulcer in the setting of a chronic abdominal aortic dissection. The patient was treated using a new stent graft capable of in situ fenestration that allowed crossing the stent-graft membrane, implanting a covered stent to exclude the re-entry at the level of the left renal artery and redirecting the blood flow through the true lumen. Conclusions This case report demonstrates the feasibility of a novel stent-graft concept. Larger studies with longer follow-up are essential to fully evaluate the safety and effectiveness of this new design.

scholarly journals Endovascular treatment of isolated abdominal aortic dissection and postoperative aortic remodeling

2015 ◽  
Vol 61 (6) ◽  
pp. 1424-1431 ◽  
Author(s):  
Qian-qian Zhu ◽  
Dong-lin Li ◽  
Ming-chun Lai ◽  
Xu-dong Chen ◽  
Wei Jin ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Endovascular Treatment ◽  
Abdominal Aortic ◽  
Abdominal Aortic Dissection ◽  
Aortic Remodeling

scholarly journals Endovascular Treatment of Isolated Chronic Abdominal Aortic Dissection

2016 ◽  
Vol 29 (3) ◽  
pp. 224
Author(s):  
Rui Machado ◽  
Duarte Rego ◽  
Luís Loureiro ◽  
Rui Almeida
Keyword(s):  
Aortic Dissection ◽  
Endovascular Treatment ◽  
Rare Event ◽  
Endovascular Intervention ◽  
Adequate Treatment ◽  
Initial Surgery ◽  
Abdominal Aortic ◽  
Long Term Follow Up ◽  
Abdominal Aortic Dissection

Isolated acute abdominal aortic dissection is a relatively rare event. Its natural history is not fully understood and its optimal treatment is not established. Open surgery represents the most described treatment but endovascular intervention has had increasing application. Isolated chronic abdominal aortic dissection  is even less described in the literature. We describe three patients with isolated chronic abdominal aortic dissection who underwent endovascular treatment in our institution. Mean age at presentation was 82 years. Indication for surgical intervention was aneurismal degeneration. Mean aortic diameter at presentation was 46.7 mm. There was no perioperative mortality or reinterventions. Mean follow-up was 5.3 years (2-12 years). Late reintervention was needed in one patient, eight years after initial surgery, due to type 1 endoleak. According to our experience, endovascular intervention represents an effective and durable treatment option in isolated chronic abdominal aortic dissection. However, long-term follow-up is mandatory. Furthermore, larger studies are still needed to understand this disease and its adequate treatment.

scholarly journals A Case of an Abdominal Aortic Dissection in a Hemodynamically Stable Marfan Syndrome Patient Presenting without Pain

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Hussein Al-Mohamad ◽  
Kara Stout ◽  
Taryn Bolling ◽  
Ronald Walsh
Keyword(s):  
Aortic Dissection ◽  
Ct Scan ◽  
Marfan Syndrome ◽  
Connective Tissue Disorder ◽  
Dissecting Aneurysm ◽  
Aortic Aneurysms ◽  
Abdominal Aortic ◽  
Fibrillin 1 ◽  
History Of ◽  
Abdominal Aortic Dissection

Introduction. Marfan syndrome (MFS) is a rare connective tissue disorder attributed to a defect in the fibrillin-1 gene. Aortic aneurysms and dissection are common causes of morbidity and mortality in Marfan syndrome. Case Report. A 43-year-old female with a history of MFS and a 4.0 cm dilated ascending aorta presented to her cardiologist reporting that since a C-section two years prior, the left side of her abdomen painlessly protruded when standing. An outpatient CT scan of the abdomen/pelvis noted a 5.5 cm abdominal aortic dissection, and she was directed to the hospital. Repeat CT scan of the abdomen/pelvis revealed a 5.6 cm dissecting aneurysm of the infrarenal abdominal aorta. The patient was admitted to the ICU and started on a nitroglycerin drip to maintain systolic blood pressure less than 110 mmHg. The patient underwent repair of her abdominal aortic dissection via a retroperitoneal approach, and she tolerated the procedure well. She was started on metoprolol tartrate 12.5 mg BID and aspirin 81 mg postoperatively. She was safely discharged with follow-up care. Conclusion. This case stresses the importance of having a low threshold to obtain imaging in a MFS patient with protruding abdomen, even though the patient may not have pain and be hemodynamically stable.

scholarly journals Spontaneous Supraceliac Isolated Abdominal Aortic Dissection Sparing Major Visceral and Renal Vessels and Presenting as Chronic Limb Ischemia

2011 ◽  
Vol 2011 ◽  
pp. 1-4
Author(s):  
Sean O. Z. Bello ◽  
Ilias Kouerinis ◽  
Woolagasen Pillay
Keyword(s):  
Aortic Dissection ◽  
Improve Patient Care ◽  
Limb Ischemia ◽  
Mesenteric Arteries ◽  
Acute Limb Ischemia ◽  
Abdominal Aortic ◽  
Renal Vessels ◽  
History Of ◽  
Abdominal Aortic Dissection ◽  
Aortic Dissections

Aortic dissections that originate from isolated tears in the abdominal aorta are uncommon. Rarer still are cases of isolated abdominal aortic dissections arising in suprarenal locations, as most appear from infrarenal intimal defects. We present a quite unusual case of a spontaneous supraceliac isolated abdominal aortic dissection sparing the renal and mesenteric arteries and manifesting as chronic rather than acute limb ischemia. The atypical presentation of this case led to repeated misdiagnosis with consequent loss of part of the patient's limb. Better illustration of the natural history of this ill-defined pathology is needed to aid understanding and improve patient care.

scholarly journals Endovascular treatment of spontaneous isolated abdominal aortic dissection

2016 ◽  
Vol 5 (12) ◽  
pp. 205846011668104 ◽  
Author(s):  
Anna Maria Giribono ◽  
Doriana Ferrara ◽  
Flavia Spalla ◽  
Donatella Narese ◽  
Umberto Bracale ◽  
...  
Keyword(s):  
Back Pain ◽  
Aortic Dissection ◽  
Endovascular Treatment ◽  
Lower Limb ◽  
Case Series ◽  
Limb Ischemia ◽  
Metal Stents ◽  
Lower Limb Ischemia ◽  
Abdominal Aortic ◽  
Abdominal Aortic Dissection

Isolated abdominal aortic dissection is a rare clinical disease representing only 1.3% of all dissections. There are a few case series reported in the literature. The causes of this pathology can be spontaneous, iatrogenic, or traumatic. Most patients are asymptomatic and symptoms are usually abdominal or back pain, while claudication and lower limb ischemia are rare. Surgical and endovascular treatment are two valid options with acceptable results. We herein describe nine cases of symptomatic spontaneous isolated abdominal aortic dissection, out of which four successfully were treated with an endovascular approach between July 2003 and July 2013. All patients were men, smokers, symptomatic (either abdominal or back pain or lower limb ischemia), with a history of high blood pressure, with a medical history negative for concomitant aneurysmatic dilatation or previous endovascular intervention. Diagnosis of isolated abdominal aortic dissection were established by contrast-enhanced computed tomography angiography (CTA) of the thoracic and abdominal aorta. All nine patients initially underwent medical treatment. In four symptomatic cases, non-responsive to medical therapy, bare-metal stents or stent grafts were successfully positioned. All patients completed a CTA follow-up of at least 12 months, during which they remained symptom-free. Endovascular management of this condition is associated with a high rate of technical success and a low mortality; therefore, it can be considered the treatment of choice when it is feasible.

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