Treatment of Visceral Malperfusion in Acute Type B Aortic Dissection by Percutaneous Endovascular Fenestration Using a Stent, with Additional Stenting of the True Lumen

Hideki Miyachi; Shiro Onozawa; Koichi Akutsu; Wataru Shimizu; Shin-ichiro Kumita; Keiji Tanaka; Satoru Murata

doi:10.1272/jnms.81.340

Case Reports

Treatment of Visceral Malperfusion in Acute Type B Aortic Dissection by Percutaneous Endovascular Fenestration Using a Stent, with Additional Stenting of the True Lumen

Hideki Miyachi, Shiro Onozawa, Koichi Akutsu, Wataru Shimizu, Shin-ichiro Kumita, Keiji Tanaka, Satoru Murata

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Keywords: acute type B aortic dissection, visceral malperfusion, fenestration

JOURNAL FREE ACCESS

2014 Volume 81 Issue 5 Pages 340-345

DOI https://doi.org/10.1272/jnms.81.340

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Abstract

Patients with acute type B aortic dissection (ABAD) are often treated medically. However, ABAD is a potentially serious emergency if complicated by acute organ ischemia. The therapeutic strategy for ABAD with visceral malperfusion remains controversial. Because emergent surgery has a high mortality rate, emergent endovascular treatment can be performed instead. We report a case of endovascular fenestration with stenting for visceral malperfusion in ABAD. One stent was inserted across the intimal flap to keep the fenestrated site open, and another stent was placed into the narrowed true lumen. This therapeutic strategy may be feasible for ABAD with acute malperfusion.

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