Combined open and endovascular repair of a DeBakey type IIIb dissection with complete distal true lumen occlusion.

摘要

We wish to report a case of chronic DeBakey IIIb dissection with complete distal true lumen occlusion treated by a hybrid approach consisting of a bifurcated graft replacement of the distal abdominal aorta together with endovascular stent-graft repair at the proximal entry tear. A 65-year-old man with a 1-year history of intermittent claudication of the right leg was found to have a chronic aortic dissection by computed tomography. He denied chest or back pain, hypertension, or cardiovascular diseases. Magnetic resonance angiogra-phy revealed a DeBakey IIIb dissection with malper-fusion of the right leg, and a proximal entry tear 3 cm distal to the left subclavian artery (Fig. 1). The maximum aneurysm diameter was approximately 5.76 cm. The true lumen was compressed by a false lumen, and became occluded 5 cm below the renal arteries. The celiac trunk, superior mesenteric and renal arteries originated from the true lumen.