Acute Type B Aortic Dissection One Month After Fenestrated EVAR Procedure.

Area of Science:

• Cardiovascular Surgery
• Endovascular Interventions
• Aortic Aneurysm Disease

Background:

• Acute aortic dissection is a rare but life-threatening complication after endovascular repair of aortic aneurysms.
• Risk factors include device oversizing, active fixation systems, and procedural injury, though late-onset dissections may be de novo.

Observation:

• A patient with a type IV thoraco-abdominal aneurysm underwent endovascular repair with a fenestrated device and iliac branch.
• One month post-procedure, the patient developed a type B acute aortic dissection extending to the endograft.

Findings:

• The dissection was successfully treated with thoracic endovascular aortic repair.
• Despite a complex recovery, the patient was discharged after 30 days.

Implications:

• Aortic dissection post-endovascular repair can compromise endografts and increase rupture risk, with reported mortality up to 30%.
• Endovascular treatment is suggested as a viable option for managing these dissections.