Complications after endovascular repair of Stanford type A (ascending) aortic dissection

Endovascular treatment has emerged as a less traumatic alternative treatment for several diseases of the thoracic aorta. However, the complications of the endovascular management of ascending aortic dissections are still high. We present a case of two iatrogenic complications after endovascular repair (EVAR) of type A (ascending) aortic dissection. Retrograde aortic dissection at the proximal part of the aortic endovascular graft and a guidewire-induced iatrogenic left ventricular pseudoaneurysm were presented in this patient after the stent-grafting procedure. Fourteen months later, surgical replacement of the ascending aorta and proximal arch was performed and the left ventricular pseudoaneurysm was treated successfully by linear closure. The patient recovered uneventfully. Although aortic endovascular grafting is apparently less traumatic, indications and potential complications related to the stent graft should be considered with great care.