[Hybrid Treatment for Delayed Lower Limb Ischemia and Aortic Dilatation Associated with Stanford Type B Aortic...

We report a case of a 65-year-old man, who was transported as an emergency case to our institution because of Stanford type B dissection. He received conservative therapy, but follow-up computed tomography(CT) revealed dilatation of descending aorta and low-enhanced range from abdominal aorta to right common iliac artery due to the expansion of the false lumen on day 11 of hospitalization. So, we attempted to perform debranch thoracic endovascular aortic repair (TEVAR), but we could not delivery the stentgraft through occluded right iliac artery. Four days later, we performed hybrid surgery of TEVAR and Y-graft replacement with reconstruction of the left renal artery. Postoperative CT showed no endoleak of TEVAR and ankle brachial pressure index (ABI) showed normal level. He was discharged on the 13th postoperative day.