Rare Case of Acute Type B Dissection Causing Complete Collapse of EVAR Stent. (July 2019)

• Record Type: Journal Article
• Authors: Ostapenko, Alexander; Richard, Michele N.; Dietzek, Alan M.
• Is Part Of: Vascular & endovascular surgery. Volume 53:Number 5(2019)
• Page Start: 420
• Page End: 423
• Publication Date: 2019-07
• Subjects: endovascular -- aortic dissection -- stent malfunction -- stent -- graft -- ischemia; Blood-vessels -- Surgery -- Periodicals; Blood-vessels -- Endoscopic surgery -- Periodicals; Vascular Surgical Procedures -- Periodicals; Angioplasty -- Periodicals; Surgical Procedures, Minimally Invasive -- Periodicals; Vascular Diseases -- surgery -- Periodicals; Vaisseaux sanguins -- Chirurgie -- Périodiques; Vaisseaux sanguins -- Chirurgie endoscopique -- Périodiques; 617.41
• DOI: 10.1177/1538574419840873
• Languages: English
• ISSNs: 1538-5744

Abstract

We describe a unique case of an acute type B aortic dissection in a patient with a history of a previously placed infrarenal aortic stent for an abdominal aortic aneurysm. The patient presented with a hypertensive emergency and left lower extremity ischemia, and imaging revealed complete collapse of the previously placed stent graft with extension into the iliac limbs. He underwent emergent endovascular intervention. When the false lumen was entered by puncturing the dissection plane with a sheath, immediate reexpansion of the stent graft was observed. The entry point of the dissection was covered with 2 overlapping stents, restoring flow within the true lumen. Although aortic stent collapse from acute type B aortic dissections is extremely rare, we demonstrate that endovascular release of the outflow obstruction and depressurizing the false lumen can resolve this dreaded complication.