Endovascular Stenting - Novel Technique in the Management of Acute Stanford Type B Aortic Dissection Involving Right-sided Aortic Arch: Is This the Way Forward? Systematic Literature Review with Case Study

Abstract

The occurrence of aortic dissection involving a right-sided aortic arch (RAA) is extremely rare. Majority of the symptomatic cases have been managed with open surgical treatment. However, middle-aged and elderly patients with coexistent comorbidities have higher postoperative risks if managed by surgery. The purpose of this case study is to review the literature for occurrence and treatment modalities for RAA with dissection, to review the various literature studies which have helped establish a consensus and guidelines in the management of aortic dissections, to review previous reported cases of successful endovascular management of RAA dissections, and to report our experience of treating a case of Stanford Type B right-sided aortic dissection managed by complete endovascular approach, the first of its kind in India. Our search in the databases revealed around 32 cases of RAA with aortic dissection published in the literature, most of which have been treated with open surgical approach; however, very few cases are managed with endovascular approach only like in our case.

Keywords

• Endovascular management of right aortic arch dissections
• right aortic arch with dissection
• right-sided aortic arch