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[Acute Type B Aortic Dissection Complicated with Malperfusion of Celiac Artery Alone;Report of a Case]

Motohiro Koyama1, Kae Ito, Keishi Ueyama

  • 1Department of Cardiovascular Surgery, Japanese Red Cross Asahikawa Hospital, Asahikawa, Japan.

Kyobu Geka. the Japanese Journal of Thoracic Surgery
|November 7, 2017
PubMed

Insights

Acute type B aortic dissection can cause celiac artery malperfusion, leading to gastric and pancreatic complications. Successful revascularization is challenging, even with collateral flow.

Area of Science:

  • Vascular Surgery
  • Cardiovascular Imaging
  • Gastroenterology

Background:

  • Acute type B aortic dissection (ATB AD) poses significant risks, including visceral artery malperfusion.
  • Superior mesenteric artery (SMA) malperfusion is often aggressively treated with revascularization.
  • Celiac artery malperfusion in ATB AD is less commonly addressed, despite potential for severe complications.

Observation:

  • A case of isolated celiac artery malperfusion secondary to ATB AD is presented.
  • Collateral blood flow from the SMA via the pancreatic arcade was noted.
  • Despite collateral supply, the patient developed ischemic gastric ulcer and pancreatitis.

Findings:

  • Catheter-based intervention is generally the primary treatment for complicated ATB AD.
  • In this case, revascularization of the celiac artery was unsuccessful as a guidewire could not traverse the ostial stenosis.
  • This highlights the technical challenges in managing isolated celiac artery malperfusion in ATB AD.

Implications:

  • Isolated celiac artery malperfusion in ATB AD requires careful consideration and management strategies.
  • Technical difficulties in revascularization may limit treatment options.
  • Further research into optimal management of celiac artery malperfusion in ATB AD is warranted.

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