Endovascular Aneurysm Repair With Re-entry Closure in a Patient With Abdominal Aortic Aneurysm Concomitant With Acute Type B Aortic Dissection

Abstract

Introduction: Abdominal aortic aneurysm (AAA) concomitant with acute aortic dissection is rare. Case report: An acute type B aortic dissection involving AAA in a 58 year old woman is described. Computed tomography angiography demonstrated that the false lumen of the abdominal aorta including the aneurysm remained patent, secondary to entry sites in the abdominal aorta, bilateral external iliac arteries, and a membrane tear of the left renal artery (LRA). The aneurysm was isolated by endovascular aneurysm repair and LRA stenting; all entry sites were occluded by endovascular treatment that included covered stenting of the LRA. Imaging performed three months after the procedure confirmed complete thrombosis of the false lumen and AAA sac shrinkage. Discussion: Endovascular treatment with covered stents is reported as an alternative strategy for treatment of AAA concomitant with acute aortic dissection involving a visceral artery.

Keywords

• AAA concomitant with aortic dissection
• EVAR
• Uncomplicated type B dissection