[Type B aortic dissection--endovascular stent-graft repair. Case report]

The treatment of aortic dissections type B Stanford using endovascular stents represents one of the newest advances in the treatment of this diseases, less invasive alternative to classic surgical repair. Aortic stent-grafts initially were used in treatment of abdominal aortic aneurysms, and then to treat aneurysms, dissections and traumatic ruptures of the descending aorta, with good early and mid-term outcomes. Thoracic aortic aneurysms are frequently diagnosed in mid-age or elderly patients who have arterial hypertension, coronary artery disease, chronic obstructive pulmonary disease. Scientific data reveal a two-year mortality rate of > 70% in untreated patients, most deaths occurring due severe haemorrhages secondary aneurysm rupture. Development of endovascular techniques is naturally, due to the inherent complications of surgery in the distal thoracic aorta (paraplegia, renal failure, stroke). Endovascular deployment of stent-grafts in the treatment of Stanford B aortic dissections represents a possible and quite safe procedure. There is a continuous debate in medical literature about the best therapeutic decision in the treatment of extensive aortic dissections. We present a case of an extensive dissection of thoraco-abdominal aorta in a 55 years old hypertensive patient treated with an aortic stent-graft. Angiograms performed at the end of the procedure revealed complete occlusion of thoracic dissection, abdominal dissection remains untouched. One and three months post procedural evaluation showed a good follow up, with partial thrombosis of abdominal dissection without renal failure or ischaemic events.