Staged endovascular treatment for complicated type B aortic dissection

Peter J. Mossop, Craig S. McLachlan, Shalini A. Amukotuwa, Ian K. Nixon

Research output: Contribution to journalArticle

66 Citations (Scopus)

Abstract

Background: A 40-year-old man presented with acute chest and back pain, hypertension and anuria. Two years previously he had been diagnosed with acute uncomplicated type B aortic dissection. Following conservative management, with aggressive antihypertensive therapy and analgesia, he was monitored with 6-monthly surveillance CT scans. These demonstrated a complicated type B dissection with renal and iliac malperfusion. Investigations: Multislice CT, transthoracic and transesophageal echocardiography, digital subtraction aortography. Diagnosis: Acute-on-chronic type B aortic dissection, complicated by aneurysmal dilatation of the thoracic aorta and visceral malperfusion. Management: Antihypertensive therapy; staged thoracoabdominal and branch vessel endoluminal repair (STABLE procedure), with stabilization of the dissection and rescue of renal function; CT imaging surveillance to monitor for any further complications.

Original languageEnglish
Pages (from-to)316-321
Number of pages6
JournalNature Clinical Practice Cardiovascular Medicine
Volume2
Issue number6
DOIs
Publication statusPublished - 1 Jun 2005
Externally publishedYes

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Keywords

  • Staged endovascular repair
  • Thoracic aortic aneurysm
  • Type B aortic dissection
  • Visceral malperfusion syndrome

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