Journal of Vascular Surgery
Volume 51, Issue 4 , Pages 993-999 , April 2010

Acute iatrogenic type A aortic dissection following thoracic aortic endografting

  • Gabriele Piffaretti, MD

      Affiliations

    • Department of Surgical Sciences - Vascular Surgery, Varese University Hospital - University of Insubria, Varese, Italy
    • Corresponding Author InformationReprint requests: Gabriele Piffaretti, MD, Department of Surgical Sciences - Vascular Surgery, Varese University Hospital - University of Insubria, Viale Guicciardini 9, 21100 Varese, Italy
    • ,
  • Giovanni Mariscalco, MD, PhD

      Affiliations

    • Department of Surgical Sciences - Cardiac Surgery, Varese University Hospital - University of Insubria, Varese, Italy
    • ,
  • Matteo Tozzi, MD

      Affiliations

    • Department of Surgical Sciences - Vascular Surgery, Varese University Hospital - University of Insubria, Varese, Italy
    • ,
  • Vito Domenico Bruno, MD

      Affiliations

    • Department of Surgical Sciences - Cardiac Surgery, Varese University Hospital - University of Insubria, Varese, Italy
    • ,
  • Andrea Sala, MD

      Affiliations

    • Department of Surgical Sciences - Cardiac Surgery, Varese University Hospital - University of Insubria, Varese, Italy
    • ,
  • Patrizio Castelli, MD, FACS

      Affiliations

    • Department of Surgical Sciences - Vascular Surgery, Varese University Hospital - University of Insubria, Varese, Italy

Received 5 August 2009 ,Accepted 14 October 2009.

  • Image Result

    Computed tomography-angiography during urgent hospital admission for acute aortic syndrome showing type B intramural hematoma (A). Six-month 3D-VR reconstruction follow-up control detected a penetrati

    Computed tomography-angiography during urgent hospital admission for acute aortic syndrome showing type B intramural hematoma (A). Six-month 3D-VR reconstruction follow-up control detected a penetrating ulcer (sketched line) of the distal portion of a type 3 aortic arch (B), protruding 16 mm (C).

  • Image Result
    Preliminary intraoperative angiography with 60° angulation (A) confirmed the origin of the ulcer (sketched line) just distally to the left subclavian artery. Final control after balloon angioplasty co

    Preliminary intraoperative angiography with 60° angulation (A) confirmed the origin of the ulcer (sketched line) just distally to the left subclavian artery. Final control after balloon angioplasty confirmed the EG correction and the absence of endoleak (B). Postoperative computed tomography-angiography: hemopericardium (arrow, C), true lumen compression (D), and entry tear at the proximal end of the EG (E).

  • Image Result
    Intraoperative finding: ascending and right pulmonary artery hematoma (A, arrow), opened arch with the intimal flap (B, arrow), proximal EG attachment site (C, sketched lines), and anastomosis between

    Intraoperative finding: ascending and right pulmonary artery hematoma (A, arrow), opened arch with the intimal flap (B, arrow), proximal EG attachment site (C, sketched lines), and anastomosis between the vascular graft and the EG (D, arrow).

 Competition of interest: none.

 The editors and reviewers of this article have no relevant financial relationships to disclose per the JVS policy that requires reviewers to decline review of any manuscript for which they may have a competition of interest.

PII: S0741-5214(09)02253-8

doi: 10.1016/j.jvs.2009.10.105

Journal of Vascular Surgery
Volume 51, Issue 4 , Pages 993-999 , April 2010

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