A 66-year-old man was admitted to our hospital because of uncomplicated Stanford B acute aortic dissection. Antihypertensive therapy was initially started; however, he suddenly experienced vomiting, diarrhea, anuria, and paraparesis on the fourteenth hospital day. Contrast-enhanced computed tomography (CECT) revealed expansion of the false lumen and severe stenosis of the true lumen at the distal aortic arch, which caused malperfusion syndrome of the lower body. Percutaneous cardiopulmonary support (PCPS) was immediately initiated to restore lower body organ perfusion, and an extra-anatomic ascending-to-abdominal aorta bypass was performed with a 16-mm Dacron graft. Postoperative CECT revealed expansion and good patency of both of the true lumen and the bypass graft. His symptoms improved except for the paraparesis; he was eventually able to ambulate using a crutch after postoperative rehabilitation.

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