Infrarenal to Innominate Artery Collateral Complicating a Chronic Residual Type B Dissection

Residual type B aortic dissection following open surgical repair of a type A thoracic aortic dissection can sometimes be complicated by collateral blood supplies, which can impact existing flow patterns and result in progressive aneurysmal dilatation of the thoracic false lumens. We report a unique case that describes the clinical presentation of an infrarenal to innominate artery collateral blood flow that complicated a chronic residual type B dissection, which was diagnosed in a timely manner using multimodality imaging, and successfully managed through an innovative minimally invasive endovascular treatment strategy (without thoracotomy) with no neurological sequela.