Endovascular Aortic Repair and Coil Embolization of the False Lumen for Chronic Stanford B Aortic Dissection: Report of a Case

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  • Hamaguchi Mari
    Department of Cardiovascular Surgery, Hyogo Prefectural Awaji Medical Center
  • Sugimoto Takaki
    Department of Cardiovascular Surgery, Hyogo Prefectural Awaji Medical Center
  • Fukase Keigo
    Department of Cardiovascular Surgery, Hyogo Prefectural Awaji Medical Center
  • Minami Hitoshi
    Department of Cardiovascular Surgery, Hyogo Prefectural Awaji Medical Center
  • Uotani Kensuke
    Department of Radiology, Hyogo Prefectural Awaji Medical Center
  • Hamanaka Akihiro
    Department of Radiology, Hyogo Prefectural Awaji Medical Center

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  • 慢性B型大動脈解離の偽腔拡大例に対し，エントリー閉鎖と偽腔塞栓術が奏功した1例

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Abstract

<p>A 76-year-old female suffered from Stanford type B aortic dissection 20 years ago. During the follow-up, the false lumen gradually expanded, and its maximum diameter became to be 55 mm at the level of abdominal aorta. Contrast enhanced CT showed the entry at distal descending aorta and reentry at bilateral distal common iliac arteries. The visceral branches arose from the true lumen, and the artery of Adamkiewicz was not identified. Endovascular treatment was indicated. Entry closure was performed with thoracic stent graft, and then closure of right-sided reentry was done with a stent graft concomitantly with coil embolization of the right internal iliac artery. Thereafter, the false lumen of the left common iliac artery was embolized via left-sided reentry using coilsand n-butyl-2-cyanoacrylate glue, preserving the left internal iliac artery. Intravascular ultrasound imaging was used to inspect thrombotic formation of the false lumen. She went an uneventful postoperative course and discharged lively 12 days after operation. Contrast enhanced CT showed complete thrombosis of the false lumen One year later, aortic diameter at the abdominal aorta level reduced to 22 mm.</p>

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