Stent Graft Implantation into a False Lumen of a Chronic Type B Aortic Dissection after Surgical Abdominal Aortic Fenestration

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  • Ito Chihiro
    Department of Cardiovascular Surgery, Chiba University Hospital
  • Ueda Hideki
    Department of Cardiovascular Surgery, Chiba University Hospital
  • Kohno Hiroki
    Department of Cardiovascular Surgery, Chiba University Hospital
  • Matsuura Kaoru
    Department of Cardiovascular Surgery, Chiba University Hospital
  • Tamura Yusaku
    Department of Cardiovascular Surgery, Chiba University Hospital
  • Watanabe Michiko
    Department of Cardiovascular Surgery, Chiba University Hospital
  • Matsumiya Goro
    Department of Cardiovascular Surgery, Chiba University Hospital

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  • 真腔閉鎖を伴った慢性 B 型大動脈解離に対して外科的開窓後に偽腔へのステントグラフト内挿術（TEVAR）を施行した1例

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<p>A 57-year-old man, who had suffered chest, back and right leg pain about 10 years before, underwent CT and was found a chronic type B aortic dissection with an enlarged false lumen and a narrowed true lumen that was occluded at the infrarenal abdominal aorta. A conventional surgical repair seemed to be too high risk considering his comorbidities, thus we chose a staged hybrid repair. First, surgical repair of the abdominal aorta with an abdominal aortic fenestration was performed. Then, one month after the first operation, zone 2 thoracic endovascular aortic repair with left carotid-axillary artery bypass was performed. At the second operation, the stent graft was purposely deployed from zone 2 into Th12 level of a false lumen through the fenestration followed by coil embolization of a true lumen just distal to the entry tear. The postoperative course was uneventful and he had no complications at 6 months follow-up. Deploying stent graft into a false lumen could be a feasible option in case deploying into a true lumen is not suitable if the anatomical condition permits.</p>

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