Endovascular stenting for type B dissection involving a right-sided aortic arch

Area of Science:

• Cardiovascular Surgery
• Vascular Medicine
• Medical Technology

Background:

• Type B aortic dissection (TBAD) management is evolving, with endovascular stent-graft repair becoming a preferred option for complicated cases.
• Right-sided aortic arch (RAA) is a rare congenital anomaly that can complicate aortic dissection management.
• Traditional surgical repair for aortic dissection involving RAA presents significant challenges.

Observation:

• A patient with type B aortic dissection and a right-sided aortic arch (RAA) presented with persistent false aneurysm expansion despite aggressive medical management.
• The anatomical complexity associated with RAA posed challenges for conventional surgical intervention.
• Endovascular repair was considered due to the limitations of open surgery and limited experience with RAA dissection.

Findings:

• The first reported case of successful endovascular stent-graft repair for type B aortic dissection involving a right-sided aortic arch (RAA) is presented.
• The procedure confirmed the technical feasibility of endovascular treatment in this rare and complex anatomical scenario.
• The patient's dissection was effectively managed using the endovascular approach.

Implications:

• Endovascular repair represents a technically feasible and potentially safer treatment option for type B aortic dissection, even in the presence of rare anomalies like RAA.
• This case expands the understanding of endovascular treatment applicability for complex aortic pathologies.
• Further research into endovascular techniques for rare aortic arch variations is warranted.