Endovascular management for ruptured Stanford B acute aortic dissection

Area of Science:

• Cardiovascular Surgery
• Vascular Endovascular Therapy
• Aortic Dissection Management

Background:

• Stanford B acute aortic dissection, particularly with rupture or malperfusion, presents significant surgical challenges.
• Traditional open surgical repair carries substantial risks in these critically ill patients.
• Minimally invasive endovascular techniques are increasingly explored for complex aortic pathologies.

Observation:

• Two patients with ruptured Stanford B acute aortic dissection were treated with endovascular therapy.
• Case 1 involved an 84-year-old woman with a massive mediastinal hematoma, treated with a homemade stent graft.
• Case 2 involved a 76-year-old man with left hemothorax, treated with an aortic extender (Excluder).

Findings:

• Both patients treated with endovascular techniques achieved successful outcomes without major immediate complications.
• The deployment of a homemade stent graft and an aortic extender proved effective in managing the ruptured dissections.
• Post-procedure recovery was favorable in both cases, highlighting the efficacy of the endovascular approach.

Implications:

• Endovascular therapy appears to be a feasible and efficient treatment option for ruptured Stanford B acute aortic dissection.
• This approach may offer a less invasive alternative to open surgery for selected high-risk patients.
• Long-term follow-up is crucial to monitor the durability and safety of endovascular repair in these complex cases.