A Case of TEVAR for Ruptured Chronic Type B Thoraco-abdominal Aneurysm

• Published in: Japanese Journal of Vascular Surgery Vol. 30; no. 4; pp. 229 - 232
• Main Authors: Ohyama, Noriko, Abe, Noriyuki, Yamazato, Takahiro, Kinoshita, Ryo, Ganaha, Fumikiyo, Munakata, Hiroshi
• Format: Journal Article
• Language: Japanese
• Published: JAPANESE SOCIETY FOR VASCULAR SURGERY 26.08.2021
• Subjects: chronic Stanford type B aortic dissection; DeBakey IIIb aortic dissection; re-entry closure; ruptured thoraco-abdominal aortic aneurysm; thoracic endovascular aortic repair
• ISSN: 0918-6778; 1881-767X
• DOI: 10.11401/jsvs.21-00041

A 71-year-old woman presented with severe chest pain persisted for one week. Her medical history included Stanford type B aortic dissection 10 years prior, obesity hypoventilation syndrome and chronic renal failure. CT revealed a diagnosis of ruptured post dissection thoraco-abdominal aortic aneurysm (TAAA). Because of the respiratory insufficiency, we abandoned open surgery and endovascular repair was performed. First, the primary entry tear was closed by TEVAR, and then the major re-entry tear at the site of detached right renal artery was closed using a covered stent bridged from the aortic true lumen to the right renal artery. There still remained false lumen backflow through another re-entry tear at detached intercostal artery, and we embolized false lumen with NBCA-Lipiodol. The false lumen was completely thrombosed, and remained nonrecanalized at one year follow-up.