Abstract
Purpose: To report a case of intimal dehiscence associated with endovascular intervention in patients with aortic dissection. Case Report A 65-year-old man presented with a type B dissection extending to the level of the common iliac arteries. Two Talent stent-grafts were placed in the descending thoracic aorta to close the entry point, but 2 lumens remained. Three days later, abdominal pain prompted another imaging session, which demonstrated a large cylindrical filling defect in the abdominal aorta ("tube-in- tube") assumed to be a partially or completely dehisced intima. Fenestration marginally improved flow to the visceral vessels, and the patient improved clinically. However, 4 days later, recurrent ischemic symptoms prompted surgery; a complete dehiscence of the aortic intima starting at the descending aorta extended to the distal abdominal aorta. The aorta was resected, but the patient died from disseminated intravascular coagulation. Conclusions: Intimal flap dehiscence associated with an endovascular procedure in the management of aortic dissection is an uncommon complication. Early detection and prompt surgical intervention of such a complication could save the patient's life. Endovascular procedures are unlikely to resolve the hemodynamic problem caused by a dehisced, distally migrated, collapsed intima.
Original language | English (US) |
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Pages (from-to) | 103-109 |
Number of pages | 7 |
Journal | Journal of Endovascular Therapy |
Volume | 12 |
Issue number | 1 |
DOIs | |
State | Published - Feb 1 2005 |
Keywords
- Abdominal aorta
- Complication
- Endovascular repair
- Intimal dehiscence
- Stent-graft
- Thoracic aorta
- Type B dissection
ASJC Scopus subject areas
- Surgery
- Radiology Nuclear Medicine and imaging
- Cardiology and Cardiovascular Medicine