Hybrid Repair Strategies for Acute Type B Aortic Dissection Complicating Prior Standard and Complex Endovascular Aortic Repair

Authors

Jesse Chait
Bernardo C Mendes
Lily E Johnston
Fahad Shuja
Gustavo S Oderich
Manju Kalra

Publication Date

6-1-2023

Journal

Journal of Vascular Surgery: Cases, Innovations and Techniques

Abstract

Type B aortic dissection (TBAD) in the presence of an existing aortic endograft is a rare, but potentially catastrophic, event. False lumen pressurization and propagation leads to several failure modes. Endograft collapse can lead to spinal cord, visceral, or lower extremity ischemia, and rupture of a previously sealed aneurysm sac is often fatal. A successful treatment strategy must incorporate the patient's symptoms, urgency of intervention, extent of dissection, and the location and status of the existing graft. In this series, we present three cases of TBAD complicating prior endovascular aortic repairs-infrarenal, iliac branched, and thoracoabdominal branched endografts-successfully treated with tailored, hybrid interventions.

Keywords

Aortic aneurysm, Aortic banding, Aortic dissection, Hybrid procedures, Ruptured aneurysm, STABLE technique