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Undersized Stent Grafts for Acute Mesenteric Ischemia in Chronic Type B Dissection
Eden C Payabyab1, Andrew H Maloney1, Derek R Brinster2
1Virginia Commonwealth University Health Systems, Richmond, Virginia.
Abstract:
Acute ischemia in chronic type B dissections carries high rates of morbidity and mortality. A 29-year-old woman with a chronic type B dissection presented with acute abdominal pain. Imaging revealed a worsening dissection with pseudocoarctation causing near complete occlusion of the true lumen by the false lumen. We placed purposefully undersized stent grafts to treat acute mesenteric ischemia by improving true lumen flow. The patient was discharged on postoperative day 4 without adverse events. We suggest that endovascular rescue by placing undersized stent grafts can provide improved flow to the mesenteric vessels with continued false lumen flow to vital organs.
Insights
This study presents a novel endovascular technique for treating acute mesenteric ischemia in patients with chronic type B aortic dissection. Undersized stent grafts successfully restored true lumen flow, improving organ perfusion and patient outcomes.
Area of Science:
- Cardiovascular Surgery
- Vascular Surgery
- Interventional Radiology
Background:
- Chronic type B aortic dissection poses significant risks, particularly when complicated by acute ischemia.
- Mesenteric ischemia in this context is associated with high morbidity and mortality rates.
