A Surgical Case of Traumatic Stanford Type B Acute Aortic Dissection Extending through Atherosclerotic Abdominal Aortic Aneurysm

• Published in: Japanese Journal of Vascular Surgery Vol. 23; no. 1; pp. 67 - 70
• Main Authors: Watanabe, Masaaki, Misawa, Yukitoki, Igari, Tsuguo
• Format: Journal Article
• Language: Japanese
• Published: JAPANESE SOCIETY FOR VASCULAR SURGERY 2014
• Subjects: abdominal aortic aneurysm; traumatic aortic dissection
• ISSN: 0918-6778; 1881-767X
• DOI: 10.11401/jsvs.13-00051

A rare case of acute and blunt traumatic aortic dissection that extended through an atherosclerotic abdominal aortic aneurysm (AAA) to the left external iliac artery will be presented. A 67-year-old man sustained a traffic injury and was transported to the emergency department of our hospital. Angiographic computed tomography (CT) of the thoracoabdomen showed Stanford type B aortic dissection and AAA of maximum 52 mm diameter. Aortic dissection extended through AAA to the left external iliac artery. At 8th day after injury the patient suffered from an ischemia of right lower extremity. Angiographic CT showed compression of the true lumen due to the dilated false lumen with no aneurysmal dilatation. Urgent operation of aneurysmectomy with fenestration and bifurcated artificial grafting was performed. The pathological specimen of the AAA demonstrated acute change of dissection. At follow-up 4 years postoperative, no expanding false lumen was noted.