Type B Aortic Dissection after Nellix Endovascular Aneurysm Sealing

Endovascular aneurysm sealing (EVAS) was developed with the intention of expanding the anatomical limitations of conventional endovascular aneurysm repair devices and decrease rates of reintervention secondary to migration and type II endoleaks in treatment of abdominal aortic aneurysms.¹ Since its inception, EVAS has gained much popularity especially for patients with concomitant common iliac aneurysms, with good long-term durability suggested by several studies. Currently, the known complications of EVAS, while considered uncommon, include endoleaks, renal artery, and limb thrombosis.² This report emphasizes the importance of vigilance in terms of early recognition of unusual complications after EVAS and describes the successful management of type B aortic dissection after EVAS, which is a novel complication of EVAS not previously described.

We describe a rare case of type B aortic dissection after EVAS and discuss the possible causes.

After diagnosis of progressive type B aortic dissection after EVAS, patient underwent emergency thoracic endovascular aortic repair with carotid to subclavian bypass for the aortic dissection with good results. He was discharged well with return to his baseline function.

Aortic dissection is a potentially catastrophic complication of EVAS and with prompt recognition and monitoring, adverse complications may be averted.