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Emergent option in complicated acute type B aortic dissection.
Keisuke Nakabayashi1, Toshikazu Shimizu2, Ken Takahashi3
1Heart Center, Kasukabe Chuo General Hospital, Kasukabe, Japan keisuke2018@gmail.com.
BMJ Case Reports
|April 29, 2022
Summary
A type B acute aortic dissection with malperfusion syndrome was successfully treated with endovascular therapy. This approach, using intravascular ultrasound, offers a rapid and effective solution when traditional surgery is unavailable.
Area of Science:
- Cardiovascular Surgery
- Vascular Endovascular Therapy
- Medical Imaging
Background:
- Acute aortic dissection is a life-threatening condition.
- Malperfusion syndrome significantly increases mortality in aortic dissection.
- Prompt diagnosis and treatment are critical for patient outcomes.
Observation:
- A 30-year-old male presented with type B acute aortic dissection and malperfusion syndrome.
- Cardiovascular surgeons and stent grafts were unavailable for immediate treatment.
- The patient underwent emergent endovascular therapy using intravascular ultrasound.
Findings:
- Stenting of the dissected superior mesenteric artery effectively resolved the malperfusion syndrome.
- Endovascular therapy proved to be a rapidly accessible and effective treatment strategy.
- Intravascular ultrasound was essential for precise stent placement.
Implications:
- Endovascular therapy is a viable and crucial option for acute aortic dissection with malperfusion, especially in resource-limited settings.
- Intravascular ultrasound enhances the safety and efficacy of endovascular interventions for complex aortic pathologies.
- This case highlights the importance of adaptable treatment strategies in managing life-threatening cardiovascular emergencies.
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