Abdominal Aortic Aneurysm Research Today is a free monthly online journal that collates and summarizes the latest research about Abdominal Aortic Aneurysm, including details on aaa (abdominal aortic aneurism), cardiac disease, treatment, symptoms, surgery. | ||||||||
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Intimal dehiscence in the abdominal aorta following balloon fenestration for type B dissection.Maynar M, Rostagno R, Zander T, Qian Z, Llorens R, Zerolo I, Castañeda WR Hospiten Rambla, Las Palmas de Gran Canaria University, Santa Cruz de Tenerife, Spain. PURPOSE: To report a case of intimal dehiscence associated with endovascular intervention in patients with aortic dissection. CASE REPORT: A 65-year-old man presented with a type B dissection extending to the level of the common iliac arteries. Two Talent stent-grafts were placed in the descending thoracic aorta to close the entry point, but 2 lumens remained. Three days later, abdominal pain prompted another imaging session, which demonstrated a large cylindrical filling defect in the abdominal aorta ("tube-in-tube") assumed to be a partially or completely dehisced intima. Fenestration marginally improved flow to the visceral vessels, and the patient improved clinically. However, 4 days later, recurrent ischemic symptoms prompted surgery; a complete dehiscence of the aortic intima starting at the descending aorta extended to the distal abdominal aorta. The aorta was resected, but the patient died from disseminated intravascular coagulation. CONCLUSIONS: Intimal flap dehiscence associated with an endovascular procedure in the management of aortic dissection is an uncommon complication. Early detection and prompt surgical intervention of such a complication could save the patient's life. Endovascular procedures are unlikely to resolve the hemodynamic problem caused by a dehisced, distally migrated, collapsed intima. Published 1 February 2005 in J Endovasc Ther, 12(1): 103-9.
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