AI Article Synopsis
- A 72-year-old man with multiple aortic aneurysms experienced a complicated case involving a stent-graft and type A dissection following treatment for pericardial tamponade.
- After initially stabilizing an intramural hematoma linked to a thoracic aortic aneurysm, he required repair with a stent-graft, which led to a type A dissection and ruptured abdominal aneurysm shortly after.
- The case highlights potential risks of stent-graft procedures, suggesting that prior hematoma may have weakened aortic wall layers, leading to the dissection despite initial stabilization.
Article Abstract
Purpose: To describe an unusual case of multiple aneurysm disease in a patient who developed stent-graft-associated type A dissection.
Case Report: A 72-year-old man presented with pericardial tamponade, which was treated with pericardial drainage. A small intramural hematoma of the ascending aorta was found originating from a proximal descending thoracic aortic aneurysm (TAA); he also had an infrarenal abdominal aortic aneurysm (AAA). After stabilization of the hematoma 7 weeks later, the TAA was repaired with a Relay stent-graft. Type A dissection followed after 3 days and acute rupture of the AAA 6 days later. Emergency surgical repair of both complications achieved successful outcome of an extended 3-stage procedure.
Conclusion: This case provides insight into the mechanisms that may contribute to stent-graft-associated type A dissection. Probably the previous separation of the aortic wall layers by the intramural hematoma triggered the complication, although the aorta appeared to have stabilized.
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| http://dx.doi.org/10.1583/08-2540.1 | DOI Listing |
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