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Successful treatment of an iatrogenic infrarenal aortic dissection with serial Wallstents
1Department of Radiology, Indiana University School of Medicine, Indianapolis, USA.
Insights
Aortic dissection after intraaortic balloon pump removal caused lower extremity ischemia. Endovascular repair with Wallstents successfully treated the dissection, restoring blood flow and leading to an uncomplicated recovery.
Area of Science:
- Vascular Surgery
- Interventional Cardiology
- Endovascular Therapies
Background:
- Acute lower extremity ischemia can be a complication following intraaortic balloon pump (IABP) removal.
- Aortic dissection, particularly involving the infrarenal aorta and iliac arteries, is a rare but serious sequela.
- Patient factors such as recent myocardial infarction and need for suprarenal aortic clamping influence treatment decisions.
Abstract:
We report a patient who presented with acute lower extremity ischemia 13 days following removal of an intraaortic balloon pump. Dissection of the infrarenal aorta, extending into the left iliac artery, was found at operation. The patient's recent myocardial infarction, prolonged ischemia with compartment syndrome, otherwise normal aortoiliac and infrainguinal arteries and the necessity for suprarenal aortic clamping for surgical repair, were all factors in the decision for endovascular repair of the dissection. Infrarenal aortic and left iliac Wallstents, placed intraoperatively, successfully occluded the false lumen of the dissection. The patient was discharged after an uncomplicated recovery and is asymptomatic with palpable pedal pulses and triphasic pedal Doppler waveforms 1 year following the procedure.