Extensive endovascular thoracoabdominal aortic septotomy for treatment of malperfusion in acute aortic dissection

Management of malperfusion in the setting of acute aortic dissection presents a challenging clinical scenario. We describe a case series of three patients with acute aortic dissection and malperfusion managed with extensive thoracoabdominal endovascular septal fenestration. In all patients, extensive aortic septotomy successfully addressed malperfusion in the acute setting, with evidence of favorable aortic remodeling at follow-up. This technique represents a viable option for the rapid management of malperfusion in the setting of aortic dissection, particularly for patients with anatomy that precludes treatment with thoracic aortic stent-graft repair.