Type B Aortic Dissection with Abdominal Aortic Aneurysm Rupture 1 Year after Endovascular Repair of Abdominal Aortic Aneurysm

Daniel, Guillaume; Ahmed, Sabrina Ben; Warein, Edouard; Gallon, A.; Rosset, Eugénio

doi:10.1016/j.avsg.2015.11.022

Cited by 6 publications

(9 citation statements)

References 10 publications

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“…Finally, device specific factors, such as anchor barbs in the bare metal stent2, 4 have been used to explain the appearance of this complication. On the other hand, the late appearance of the dissection would be more related to a spontaneous aortic dissection 3, 5, 6. An increased diameter of the thoracic aorta could also be related to the appearance of a type B aortic dissection 7 …”

Section: Discussionmentioning

confidence: 99%

Acute Type B Aortic Dissection One Month After Fenestrated EVAR Procedure

Czaplicki

Sifuentes

Aldama

2019

EJVES Short Reports

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Introduction Acute aortic dissection after endovascular repair of an aortic aneurysm is a rare but serious condition, with potential complications that can result in the death of the patient. Report This is the case of a patient diagnosed with a type IV thoraco-abdominal aneurysm with involvement of both iliac arteries who underwent endovascular repair with a four fenestration device and a left iliac branch. One month after the procedure, the patient presented with a type B acute aortic dissection that extended from the left subclavian artery to the proximal stent of the fenestrated graft. This dissection was treated by thoracic endovascular aortic repair, and after a problematic post-operative period, the patient was discharged after 30 days. Discussion Occurrence of an acute aortic dissection after endovascular repair of an aortic aneurysm has rarely been reported in the literature. Development of these dissections has been related to factors such as excessive oversizing, use of devices with active fixation systems, or injuries during the procedure, although it is believed that the late onset would indicate that it was a de novo dissection. The presence of an aortic dissection can lead to the collapse and occlusion of the previous endograft and even to aortic rupture, and mortality in reported cases reaches 30%. The authors suggest that endovascular treatment should be considered in these patients.

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Section: Discussionmentioning

confidence: 99%

Acute Type B Aortic Dissection One Month After Fenestrated EVAR Procedure

Czaplicki

Sifuentes

Aldama

2019

EJVES Short Reports

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“…There are 10 reports of similar antegrade complicated TBAD in the literature, excluding retrograde dissection (Table 1). 1 –10 Primary entry tears were found in the distal left subclavian artery in all cases. Different devices were used: 4 Excluder, 3 Zenith, 2 Endurant (Medtronic, Inc, Minneapolis, Minnesota), and 1 Talent (Medtronic, Inc).…”

Section: Discussionmentioning

confidence: 84%

“…Endograft collapse was reported in 8 cases, 1 –6,9,10 endograft thrombosis was reported in 8 cases, 2,4 –10 and rupture was reported in 2 cases. 1,7 Endograft collapse occurred with the 4 stent grafts (Excluder, Zenith, Talent, and Endurant). As endograft collapse is defined by false lumen pressure, the radial force of the devices is not associated with the events.…”

Section: Discussionmentioning

confidence: 99%

“…Among the rupture cases, treatment was not possible in one case, 1 and open abdominal aortic repair was performed in the other case. 7 The patient died because of multiorgan failure on postoperative day 4.…”

Section: Discussionmentioning

confidence: 99%

“…Several studies have reported that new-onset complicated TBAD after endovascular aneurysm repair (EVAR) is extremely rare. [1][2][3][4][5][6][7][8][9][10] The extension of aortic dissection causes various symptoms and can destabilize the stent graft. In addition, a stent graft can result in various symptoms.…”

Section: Introductionmentioning

confidence: 99%

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Fatal Complications of New-Onset Complicated Type B Aortic Dissection After Endovascular Abdominal Aortic Aneurysm Repair: Report of 2 Cases and Literature Review

Nomura

Nagao

Hasegawa

et al. 2018

Vasc Endovascular Surg

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New-onset antegrade Stanford type B aortic dissection (TBAD) after endovascular aneurysm repair (EVAR) for abdominal aortic aneurysm (AAA) is rare. The extension of aortic dissection leads to various symptoms and affects the stent graft. Moreover, various symptoms may arise owing to a stent graft being present. We describe 2 cases of complicated acute TBAD occurring after EVAR, which were ultimately fatal. The case in which rupture occurred could not be treated and the patient died. In another case with bilateral lower extremity malperfusion caused by collapse and occlusion of the endograft, extra-anatomical bypass was performed. Although the collapsed endograft gradually re-expanded, the patient ultimately died because of multiorgan failure. We have reviewed the literature and analyzed the treatment of complicated TBAD after EVAR.

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