Salvaging From Limb Amputation in an Acute Complicated Type B Aortic Dissection Patient

Aortic dissection is a condition in which there is an intimal tear that allows the blood to pass through the tear and into the aortic media, splitting to a true lumen and a newly formed false lumen. It is associated with genetic disorders such as Marfan syndrome, Ehlers-Danlos syndrome, and Loeys-Dietz syndrome, or may result from cardiovascular risk factors including smoking, hypertension, and familial hyperlipidemia.

The aim this article was to report a complicated Stanford B aortic dissection with acute limb ischemia and compartment syndrome, successfully managed with limb preservation and aortic repair.

A 60s male patient with poorly controlled hypertension presented with severe chest pain radiating to the back and right leg ischemia, characterized by coldness, numbness, motor loss, and absent arterial pulses.

The patient was treated with intensive medical management, including pain control, heart rate and blood pressure stabilization, while preparing for emergency intervention. A thoracic aortic endovascular stent-graft was placed to seal the entry tear and restore blood flow to the right lower limb. The intervention utilized a Relay thoracic stent-graft (32-28 mm diameter, 200 cm length, Bolton Medical), with access via the left common femoral artery Stanford Type B aortic dissection complicated by limb ischemia is a cardiovascular emergency requiring urgent intervention.

Timely monitoring, insight consultation with orthopedic physician to understand the pathophysiology of acute compartment syndrome, the importance of early diagnosis and precise management of acute compartment syndrome following intervention are crucial to preserving the limb and ensuring the success of endovascular aortic repair.