Abdominal stent-graft collapse due to progression of a Stanford type B dissection.

摘要

We present a 74-year-old man who was referred to our hospital with severe abdominal pain, oliguria, and laboratory findings compatible with early renal insufficiency due to progression of a Stanford type B aortic dissection. Two years earlier, the patient has undergone en-dovascular aneurysm repair (EVAR) to exclude a 5.4-cm abdominal aortic aneurysm with a Talent aortomonoiliac stent-graft (Medtronic Cardiovascular, Minneapolis, MN, USA) and a femoral-femoral crossover bypass. One and a half years after this operation, he developed an acute type B dissection; the intimal flap originated just distal to the origin of the left subclavian artery and extended to just above the stent-graft at that time. The dissection was treated conservatively with antihypertensive agents; no progression of the dissection was seen in the following 6 months on computed tomographic angiography (CTA).