A successful case of two-staged operation for Stanford type B acute dissecting aneurysm complicated with total occlusion of the distal abdominal aorta

• Published in: Kyobu geka. The Japanese journal of thoracic surgery Vol. 47; no. 10; p. 825
• Main Authors: Moriyama, Y, Toyohira, H, Masuda, H, Koga, M, Saigenji, H, Shimokawa, S, Taira, A
• Format: Journal Article
• Language: Japanese
• Published: Japan 01.09.1994
• Subjects: Acute Disease; Acute Kidney Injury - etiology; Anastomosis, Surgical - methods; Aneurysm, Dissecting - surgery; Aorta, Abdominal; Aortic Aneurysm, Thoracic - surgery; Arterial Occlusive Diseases - etiology; Humans; Ischemia - etiology; Leg - blood supply; Male; Middle Aged; Reoperation
• ISSN: 0021-5252

A successful case of two-staged operation for Stanford type B acute dissecting aneurysm complicated with total occlusion of the distal abdominal aorta was reported. A 62-year-old male patient with a long history of systemic hypertension developed acute severe chest, back and bilateral legs pain. An enhanced CT demonstrated Stanford type B dissecting aneurysm with occlusion of the left renal artery and bilateral common iliac arteries. On the day of admission, an emergent right axillo-femoral bypass operation using 8 mm ringed EPTFE graft was undertaken to rescue the ischemic legs. The patient's postoperative course was complicated with acute renal failure and paralytic ileus, which were treated with medical treatment. Four months later, the second operation was done for the localized residual dissecting aneurysm in the proximal descending thoracic aorta. The aneurysm was excised, and the entry was closed with Dacron patch using the previously placed axillo-femoral bypass as a technique for preventing distal ischemia. He was recovered uneventfully and was discharged in a good condition.